National Rally Isle of Man 2017 (Nat B) Internet Entry Form

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

Welcome to the National Rally Isle of Man Online Entry system, a dual permit National A and B event.

This Entry Form is for the National B permit only. Classes N1-N7 & H1-H7 only. a National B licence is required, Please check the SR's for which event your Championship is eligible.

Entries Close for seeding on Wednesday 23rd August at 21.00 hrs.

Sally Helwich

Entries Secretary
Rally Isle of Man
Unit 10a
Tromode Industrial Estate
Tromode
Isle of Man
IM4 4QB

Telephone: +44 (0) 1624 852440

E-Mail: entries@rally.im

Held under the General Regulations of the Motor Sports Association (incorporating the International Sporting Code of the FIA) 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.
  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. There are then two ways to pay
    1. If you have internet or telephone banking, you can arrange for the fees to be paid directly into our account. The details are:-
      Bank Barclays
      Sort Code 20-26-74
      Account No. 70304271
      Account Name Manx Rally Services
      IBAN GB46 BARC 20267470304271
      BIC BARCGB22
      Reference Driver's full name.
    2. You can send a cheque, made payable to 'Manx Rally Services' to the Entries Secretary at the address above. Please include drivers name on back of Cheque
  4. Within 72 hours of us receiving the payment for your entry you should receive an e-mail confirming your entry from the Rally Co-ordinator. NOTE: WITHOUT PAYMENT YOUR ENTRY WILL NOT BE VALID.
  5. If you don't receive a response within 4 days of the expected payment date, or if you have any other questions, please e-mail entries@rally.im 
  6. Entry Fee with Travel Package includes Van+Trailer (total combined length of 10.5m) plus two adults.  To complete the travel booking and to order additional meters for longer vehicles and/or additional passengers please contact: IoM Events Ltd. on 01624664460 or e-mail info@iomevents.com . To confirm you place on the boat it is advisable to book this early!
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/Home Town
Driver Publicity
Hobbies
Married?
No of Children
How Long Rallying?
Notable Results
Any other information
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
Telephone Number
Mobile Number
Competition Licence Number
Competition Licence Issuer
E-Mail Address
Club
Date of Birth
Nationality/Home Town
Co-Driver Publicity
Hobbies
Married?
No of Children
How Long Rallying?
Notable Results
Any other information
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
Year and registered Championship Class
Forced Induction
Four Wheel Drive
Event Class entered
In Car Camera Request
Insurance

If you require cover under the REIS Event Road Section Scheme, payment may be made with your entry or at Admin Checks.

New applicants wishing to use the scheme must be able to comply with all the points of the Insurance Criteria

If you are arranging your own Road Traffic cover, please provide details below.
Name
Address
Recce Vehicle
Make
Model
Colour
Registration Number
Contact Name
Contact Number
Service Vehicle
Make
Model
Colour
Registration Number
Contact Name
Contact Number
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
MSA British Rally Championship National Rally Cup
Crew Members Registered
Driver Championship Registration Number
Co-Driver Championship Registration Number
HRCR Old Stagers Asphalt Historic Championship inc Mini Cup
Crew Members Registered
Driver Championship Registration Number
Co-Driver Championship Registration Number
RAC Historic Asphalt Rally Championship
Crew Members Registered
Driver Championship Registration Number
Co-Driver Championship Registration Number
HRCR Stage Masters Challenge
Crew Members Registered
Driver Championship Registration Number
Co-Driver Championship Registration Number
Eurocars Motorsport Manx Rally 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 PositionNo of Starters
Seeding - Competitor Opinion
Out of 50 entries, where do you think you should be seeded?
RECONNAISSANCE
Participating in Recce?

Select 1 period only (see Regs for Details)

Participating in Shakedown?
Fees - see above for how to pay
Entry Fee £
Club Membership £
Insurance £
Shakedown Stage£
We Support “The Marshals” stickers @ £5.00 each£
Mandatory Safety Tracker- Cost TBA£
Additional width of Service Bay, If unsure, please contact Rally Office to discuss this before booking£
Electric Point where available at cost of £80, Please book this early directly with Rally Office and pay at Documentation£
Total Money to be sent£
Payment Method and Details
Entrant (if applicable and not driver)
Name
Address
Post Code
Telephone Number
Nationality
Competition Licence Number
Competition Licence Issuer
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.

Declaration of Indemnity

 

I declare that:

1. I have been given an 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
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.

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

3. 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 the vehicle, I may not take part unless I have declared such
disability to the ASN who have, following such declaration, issued a licence which permits me to do so.

4. Any application form for a licence which was signed by a person under the age of 18 years was countersigned by
that person’s parent/guardian/guarantor, whose names and addresses have been given.

5. If I am the parent/guardian/guarantor of the driver “I understand that I shall have the right to be present during any
procedure being carried out under the Supplementary Regulations issued for this event and the General Regulations of
the MSA. As the Parent/Guarantor “I can confirm that I have acquainted myself with the MSA General Regulations,
agree to pay any appropriate charges and fees pursuant to those Regulations (to include any appendices thereto) and
hereby agree to be bound by those Regulations and submit myself without reserve to the consequences resulting from
those Regulations (and any subsequent alteration thereof). Further, I agree to pay as liquidated damages any fines
imposed upon me up to the maxima set out in MSA General Regulations Part 3, Appendix 1”

Note: Where the parent/guardian/guarantor of the driver is not present there must be a representative who must
produce a written and signed authorisation to so act from the parent/guardian/guarantor as appropriate.

I hereby agree to abide by the MSA Child Protection Policy and Guidelines.

I undertake that at the time of the event to which this entry relates I shall have passed or am exempt from an ASN specified medical examination within the specified period.

 

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