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Rainworth SKODA Dukeries Rally 2017 Internet Entry Form

Entries open at 6.00pm on Monday 10th July.

Entries close for Seeding on Thursday 10th August.

Entries finally close for any late entries on Wednesday 16th August.

Entries Secretary: Joanne Smith

12 Breckbank, Forest Town, Mansfield, Notts. NG19 0PZ

Telephone 01623 480410 (Evenings before 9.00pm ONLY)

Email: entries@dukeries-rally.co.uk

ENTRY SUBMISSIONS WITH MINIMAL INFORMATION WILL BE RETURNED AND THE ENTRY WILL NOT BE ACKNOWLEDGED.

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

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 and must be filled in otherwise you will not be able to continue.
  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. When your entry has been checked you will receive a further email with a receipt number - this is an acknowledgement - NOT an acceptance.
  4. There are TWO ways to pay
  5. If you have internet or telephone banking, you can arrange for the fees to be paid directly into our account.

The details are:-

Bank Co-operative Bank
Sort Code  08-92-99
Account No.  65342240
Account Name Dukeries MC Events Account
Reference Driver's First name and Surname

Alternatively you can use PayPal by visiting the Competitor page of the event website, www.dukeries-rally.co.uk  - (the PayPal admin fees are included in this sum)

(Debit/Credit Cards can be used through the PayPal facility and the same PayPal charges apply).

Within 24 hours of us receiving the payment for your entry you should receive an e-mail confirming "Acceptance" of your entry from the Entries Secretary.

Entries are secured only by receipt of a FULLY PAID entry fee, until this fee is received your entry status is "Acknowledged" - "NOT Accepted"

If you delay paying the entry fee after submitting your entry, later entries that include the entry fee will take presidence.

If you don't receive a response within 3 days of the expected payment date, or if you have any other questions,please e-mail: entries@dukeries-rally.co.uk 

 

Document Addressing
E-Mail address for communication (Ideally one that works)
Real Name of this person
Who should we send relevant Entry and Venue Passes along with Final Instructions to?
Driver
Full Name
Address
Post Code
Home Town
Contact Telephone Number
Competition Licence Number
E-Mail Address (Please check it is correct)
Club
Driver Publicity
Hobbies other than Rallying?
How Long Rallying?
Notable Results
Any other information or Interesting stories regarding your Rallying career?

 

 

To be used as Information for the Programme and Circuit Commentator.

Driver's Parent or Guardian (under 18 only)
Name
Address (if different)
Post Code
Telephone Number
Relationship
Co-Driver
Full Name
Address
Post Code
Home Town
Contact Telephone Number
Competition Licence Number
E-Mail Address (Please check it is correct)
Club
Co-Driver Publicity
Hobbies other than Rallying?
How Long Rallying?
Notable Results
Any other information or Interesting stories regarding your Rallying career?

 

 

 

To be used as Information for the Programme and Circuit Commentator.

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
Forced Induction
Four Wheel Drive
Class
Sponsor
Sponsor Name (Note: this sponsor does not need an entrant's licence.
If you have an entrant with an entrant's licence,
please give details later.
Championships
MAXXIS MSA English Rally Championship
Crew Members Registered
Driver Championship Registration Number
Co-Driver Championship Registration Number
Heart of England Stage Rally Championship
Crew Members Registered
Driver Championship Registration Number
Co-Driver Championship Registration Number
The Alexander Calder Financial EMAMC Stage Rally Championship (Supported by Slicks Tyres)
Crew Members Registered
Driver Championship Registration Number
Co-Driver Championship Registration Number
Roadrunner / Phoenix Awards Stage Rally Championship (supported by Pantry Catering & Slicks Tyres)
Crew Members Registered
Driver Championship Registration Number
Co-Driver Championship Registration Number
Dukeries MC Championship
Crew Members Registered
Driver Championship Registration Number
Co-Driver Championship Registration Number
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
Event Name and ClubYearTypeSurfaceOverall Position

Class Position

Seeding - Competitor Opinion
Out of 80 entries, where do you think you should be seeded?
Entry and other fees - See above for how to pay.
Entry Fee(s) - Select from Drop Down Menu (Bank Transfer or PayPal on all items required) £
Dukeries MC Membership till 31/12/2017 £
SORRY - SOLD OUT£
Total Money to be sent£
Payment Method - Indicate how you will be paying for your entry.
Entrant (if applicable and not driver)
Name
Address
Post Code
Telephone Number
Competition Licence Number
Marshal Details
Name
Address
Post Code
Telephone Number
Mobile Number
Email Address
Experience

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.

The automated acknowledgement email is NOT confirmation of your entry, it just indicates that it has been received.

Reserve entries will be informed by e-mail if and when they have secured an entry to the supplied e-mail address.

By clicking on the "Enter the Rally" button below you agree to the following:

NO Animals, No Drone Aircraft or Drone Mounted Cameras are permitted within Donington Park Motor Racing Circuit including the Paddock areas.  

There must be NO starting or running of ANY competition engine between 18.30 on Saturday 19th August and 9.00am on Sunday 20th August. Any violation for whatever reason will mean Exclusion from the event   These are conditions imposed by the Circuit Management.

'I declare that I have been given the opportunity to read the General Regulations of the Motor Sports Association and, if any, the Supplementary Regulations for this event and agree to be bound by them. I declare that I am physically and mentally fit and competent to take part in the event. I understand that motorsport is dangerous and accidents causing death, injury, disability and property damage can and do happen. I understand that these risks may give rise to my suffering personal injury or other loss and I acknowledge and accept these risks.

‘In consideration of the acceptance of this entry I agree that neither any one of or any combination of the MSA and its associated clubs, the organisers, the track owners or other occupiers, the promoters and their respective officers, servants, representatives and agents (the “Parties”) shall have any liability for loss or damage which may be sustained or incurred by me as a result of participation in the Event.

Nothing in this clause is intended to or shall be deemed to exclude or limit liability for death or personal injury.

To the fullest extent permitted by law I agree to indemnify and hold harmless each of the Parties in respect of any loss or damage whatsoever and howsoever arising from my participation in the Event.

'I declare that to the best of my belief the driver(s) possess(es) the standard of competence necessary for an event of the type to which this entry relates and that the vehicle entered is suitable and roadworthy for the event having regard to the course and the speeds which will be reached'.

‘I understand that should I at the time of this event be suffering from any disability whether permanent or temporary which is likely to affect prejudicially my normal control of my 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.’

'I hereby agree to abide by the MSA Child Protection Policy and guidelines and the National Code of Sporting Conduct'.

 

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