Dennis Motorsport Epynt Hillclimbs 2017 Internet Entry Form

Online Entry System

Held under the General Regulations of the Royal Automobile Club Motor Sports Association Ltd (MSA) (incorporating the International Sporting Code of the FIA) the Supplementary Regulations and any written instructions the Club may issue for the Event.

 Entries Close on 10th June 2017.

  


 

Please follow the steps below to enter the event:

 

1. Complete all the fields in the form below. The fields with red backgrounds are mandatory. These must be filled in or you will not be able to continue

2. WITHOUT PAYMENT YOUR ENTRY WILL NOT BE ACCEPTED - There are two ways to pay

 

 

Bank  HSBC Bank plc, Brecon, Powys. LD3 7AH
Sort Code  40-13-20
Account No.  11234633
Account Name Brecon Motor Club
Reference Please use Driver's full name

 

 

3. 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  

4. Within 24 hours of our receiving the payment for your entry you should receive an e-mail acknowledging your entry and payment from the Entries Secretary.  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 david_thomas@btinternet.com

IMPORTANT

Please ensure that  ALL parts of the form are completed. If you are unsure of any details when completing your entry form please use TBA. However this information MUST be forwarded to the Entries Secretary via email as soon as possible in order to allow the entry to be processed and BEFORE the close of entries.
If you have any other queries or questions please do not hesitate to contact the Entries Secretary:

 

David Thomas

13 Oakfield Drive, Crickhowell, NP8 1DR.  

Tel: 01873 810870

Mob: 07540 989710

E-mail:   david_thomas@btinternet.com

Document Addressing
E-Mail address for communication
Real Name of this person
Whom should we send Finals and Results to?
Driver
Full Name
Address
Post Code
Home Town
Telephone Number
Mobile Number
Competition Licence Number
Competition Licence Issuer
E-Mail Address
Club
Date of Birth
Nationality
Driver Publicity
Hobbies
Married?
No of Children
How Long Competing?
Notable Results
Any other information
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
Year
Forced Induction
Four Wheel Drive
Class
Championships
The Trident Engineering 2017 Welsh Sprint & Hillclimb Championship
Crew Members Registered
Driver Championship Registration Number
The TVR Car Club Speed Championship 2017
Crew Members Registered
Driver Championship Registration Number
The HRCR Speed Series 2017 Historic Hill Climb & Sprint Championship
Crew Members Registered
Driver Championship Registration Number
The Petro-Canada Lubricants Porsche Club National Hill Climb Championship 2017
Crew Members Registered
Driver Championship Registration Number
The Revington TR/TR Register Sprint & Hill Climb Championship 2017
Crew Members Registered
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?
Fees - see above for how to pay
Entry Fee £
Club Membership £
Total Money to be sent£
Payment Method and Details
Entrant (if applicable and not driver)
Name
Address
Post Code
Competition Licence Number
Competition Licence Issuer
Events
Which days to you wish to enter?

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 consent to the organising committee using the information I have given for the purpose of displaying relevant details on an entry list to be made available to the public via written and electronic means, and for mailings to promote future editions of the Harry Flatters Rally.  The information provided will be treated in confidence and will be held in compliance with the Data Protection Act 1998.  Crews personal details will be shared with members of the Rally and BMC Committees and address labels/e-mail addresses provided to the Media Officer and Official Photographers/Media of the event for the purposes of distributing Press Releases and advertising their services.  I understand you cannot verify that the Official Photographers/Media will not share such information with other organisations or individuals.
 
MSA INDEMNITY 

Held under the General Regulations of the Royal Automobile Club Motor Sports Association Ltd (MSA) (incorporating the provisions of the International Sporting Code of the FIA) these Supplementary Regulations and any written instructions the Club may issue for the Event.

I declare that:-

 

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