DCC Stages 2017 Internet Entry Form

Entries to this event are now closed and this page is for record only

The DCC Stages - 1st APRIL 2017

Entries Secretary: Douglas Smith

Telephone 07901 955 054 (Evenings before 9pm only)

e-mail: douglasxsmith7550@gmail.com

Held under the General Regulations of the Motor Sports Association (incorporating the International Sporting Code of the FISA) and the Supplementary Regulations

Entry form for DCC Junior Stages on Sunday 2nd April can be found here

Online Entry system.

Please follow the steps below to enter the rally.

  1. Complete all the fields in the form below. The fields with red backgrounds are mandatory.
  2. Once you have hit the "Enter the Rally" button at the end you will receive an automated response confirming we have received your entry form.
  3. The year we are only accepting electronic payments.

To be fair to all competitors and to allow for time to allocate payments, once entered you have 48 hours to make payment, the entry list will not be updated until Wednesday evening

The bank details are:-

Bank RBS
Sort Code 83-19-01
Account No. 00140673
Account Name DCC
Reference Driver's Surname

Alternatively the payment can be made at any branch of the RBS quoting our accounts details and ensuring your name is included on the narrative.

If you wish to make payment by PayPal there is an additional payment of £8 payable to cover the PayPal fees.

NOTE: WITHOUT PAYMENT YOUR ENTRY WILL NOT BE ACCEPTED

All the fields with a red background must be filled in, or you will not be able to continue

Document Addressing
E-Mail address for communication
Real Name of this person
Driver
Full Name
Address
Post Code
Contact Number
Competition Licence Number
E-Mail Address
Club
Date of Birth (if aged under 18)
Driver's Parent or Guardian (under 18 only)
Name
Address (if different)
Post Code
Telephone Number
Relationship
Co-Driver
Full Name
Address
Post Code
Contact Number
Competition Licence Number
E-Mail Address
Club
Date of Birth (if aged under 18)
Co-Driver's Parent or Guardian (under 18 only)
Name
Address (if different)
Post Code
Telephone Number
Relationship
Car
Make
Model
Colour
Registration Number
Engine Capacity (cc)
Forced Induction
Four Wheel Drive
Class
In Car Camera Request
Service Vehicle - Only this vehicle will be allowed access to the venue
Championships
Blackwood Plant Hire Scottish Tarmack Rally Championship
Crew Members Registered
AS Performance North Of England Rally Championship
Crew Members Registered
The Borders Challenge
Crew Members Registered
Person to be contacted in case of serious accident to Driver
Name
Address
Post Code
Telephone Number
Relationship
Will this person be attending the event?
Person to be contacted in case of serious accident to Co-Driver
Name
Address
Post Code
Telephone Number
Relationship
Will this person be attending the event?
Seeding - Past Performance on Rallies since 1 Jan 2014
Event Name and ClubYearSurfaceOverall Finishing PositionNo of Starters
Seeding - Competitor Opinion
Out of 75 entries, where do you think you should be seeded?
Fees - see above for how to pay
Entry Fee £
Marshals contribution£
Total Money to be sent£
Payment Method and Details
Comments
Anything else you'd like to tell us

The details on this form will be held on computer in order to be used for the administration of this event. They will also be used to send you information about future events organised by this club, unless you untick this box to indicate you do not wish to receive information on further events.
The details on this form may also be passed on to other motorsport organisations, unless you untick this box to indicate you do not wish these details passed on.

Remember your entry is subject to receipt of the correct entry fee. An automated acknowledgement is NOT confirmation of entry.

Rejected entries and entries held in abeyance will be informed by e-mail to the address(es) given above.

By clicking on the "Enter the Rally" button below you agree to the following: "I declare that I have been given the opportunity to read the General Regulations of the Motor Sports Association and the Supplementary Regulations for this event and agree to be bound by them. I declare that I am physically and mentally fit to take part in the event and I am competent to do so. I acknowledge that I understand the nature and type of the competition and the potential risk inherent with motor sport and agree to accept that risk. Further, I understand that all persons having any connection with the promotion and/or organisation and/or conduct of the event are insured against loss or injury caused through their negligence."

I declare that the use of the vehicle hereby entered will be covered by insurance as required by the law, which is valid for such part of the event that shall take place on roads as defined by the law.

I understand that should I, at the time of the event be suffering from any disability whether permanent or temporary which is likely to affect prejudicially my control of the vehicle. I may not take part unless I have declared such disability to the ASN which has, following such declaration issued a licence which permits me to do so.

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