JJ Brown Memorial Rally ~ 9th/10th December 2017 Internet Entry Form

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

J.J. Brown Memorial Rally
in association with O.G.Owen & Son Ltd. of Caernarfon

Entries Close at 20.00 hours on Wednesday, 6th December, 2017

Entries Secretary: Ifor Davies

Llecyn

Pencaenewydd

PWLLHELI

Gwynedd

LL53 6RB

Tel: 07773 297043

E-Mail: jjbrownrally@gmail.com

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

Welcome to the Caernarvonshire & Anglesey Motor Club Ltd, J.J. Brown Memorial Rally 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. Please note that this is a Clubman Status event and all competitors must be members of C&A Motor Club. Forms may be downloaded from the club's website and presented at signing on.
  3. Please read Section 7 of the Supplementary Regulations to determine which class you should enter.
  4. 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.
     
  5. YOU HAVE A CHOICE OF THREE WAYS TO PAY:
    A)  If you would like to pay via credit card, debit card or PayPal, you will see a link after you complete the entry form to take you to PayPal's website, where you can pay for your entry by card or PayPal (use the reference: JJB + driver's name).  Note that we do not see your card details at all as this is all handled for us by PayPal (you will be charged a 4% surcharge for this facility).

    B) If you have internet or telephone banking, you can arrange for the fees to be paid directly into our account. The details are
    Bank HSBC
    Sort Code  40-16-02
    Account No.  01166034
    Account Name C&A Motor Club

    Use the reference:

    JJB + Driver's name

    C) You can send a cheque, made payable to 'Caernarvonshire & Anglesey Motor Club Ltd' to the Entries Secretary at the address above (your entry will not be confirmed until the cheque is cashed).

    All other fees due will be collected at signing-on, that is, JELF insurance premiums and/or C&A Motor Club club membership fee.

    All the fields with a red background must be completed, otherwise you will not be able to continue.

  1. Within 3 days of us receiving the payment for your entry you should receive an e-mail confirming your entry from the Entries Secretary. NOTE: WITHOUT PAYMENT YOUR ENTRY WILL NOT BE VALID.
  2. If you don't receive a response within 7 days of the expected payment date, please e-mail jjbrownrally@gmail.com

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 - PLEASE ENTER CAREFULLY.
Real Name of this person
Driver
Name (no nicknames allowed).
Address
Post Code
Telephone Number
Mobile Number
E-Mail Address
Date of Birth if under 21 years old
Driver's Parent or Guardian (under 18 only)
Name
Address (if different)
Post Code
Telephone Number
Relationship

Navigator

Name (no nicknames allowed)
Address
Post Code
Telephone Number
Mobile Number
E-Mail Address
Date of Birth if under 21 years old
Navigators's Parent or Guardian (under 18 only)
Name
Address (if different)
Post Code
Telephone Number
Relationship
Car & Class
Make
Model
Colour
Registration Number
Cubic Capacity
Class
Insurers (If using JELF you must comply with the Supplementary Regulations and write JELF as Insurers name)
Will you be using JELF's Insurance scheme?
If NOT using JELF please provide the details of your own insurers.

 

      Name

      Address

      Policy no

Person to be contacted in case of serious accident to Driver
Name
Telephone Number
Relationship
Person to be contacted in case of serious accident to Navigator
Name
Telephone Number
Relationship
Seeding - Past Performance on Rallies

Event Name

Year

Status

Class Entered

Class Position

Overall Position

Fees - see above for how to pay
Entry Fee £
Total Money to be sent£
Payment Method
Marshal Details
Name
Mobile Number
Email Address

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.

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.."

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