Motordrive Seats Lee Holland Memorial Rally March 19th 2017 Internet Entry Form

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

Lee Holland Memorial Rally March 19th  2017

In Association With

MOTORDRIVE SEATS

 

www.pendledistrictmc.co.uk

 

 

  

Welcome to the 2017 Motordrive Seats Lee Holland Memorial  Stages March 19th

With a number of firsts for the event and Pendle District & Garstang &Preston Motor Clubs Club together with being round 6 of the excting new Motorsport News Circuit Rally Championship in a/w MSVR, we are sure you will really enjoy this years rally.

 

Entries Open 23rd January 2017 @ 20:00 at  £275:00

Entries Close for seeding on 12th March 2017

Entry Tickets posted to fully paid entries- 14th March 2017

**NOTE

Entries SECRETARY:-

Rod Brereton

2 Parkside

Sough

Barnoldswick

BB18 6TA


Telephone 01282 843297 OR 07952377880  (Between 19:00 and 21:00)

e-mail: pdmc@clara.co.uk

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

Welcome to the "Motordrive Seats Lee Holland Memorial Stages March 19th 2017 " 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. There are several ways to pay your entry
    1. PayPal - info@gpmc.org.uk - to use this option a charge of 4.0% is made by the club, to cover fees.
    2. Cheque (To the entry secretaries address payable to Lee Holland Memorial Rally)
    3. Cash (Delivery in person to the entry secretary)
    4. If you have internet or telephone banking, you can arrange for the fees to be paid directly into our account. The details are:-
      Bank  Lloyds TSB
      Sort Code 77-76-05
      Account No. 46829260
      Account Name LEE HOLLAND RALLY
      Reference

      Drivers Full Name (Failure to provide this will delay your application)

  4. Within 24 hours 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 (this includes reserves places).FULL PAYMENT MUST BE MADE WITHIN 5 DAYS OF RECIEPT OF ENTRY
  5. If you don't receive a response within 5 days of the expected payment date, or if you have any other questions, please e-mail  pdmc@clara.co.uk

 

All the fields with a red background must be filled in, or you will not be able to continue. Please put TBA in any red field which you do not know the details for and, as soon as these details are known, please email them to the entries ecretary.

Document Addressing
E-Mail address for communication
Real Name of this person
Whom should we send final instructions and entry tickets to?
Driver
Full Name
Address
Post Code
Home Town
Telephone Number
Mobile Number
Competition Licence Number
Competition Licence Issuer
E-Mail Address
Club(If no club is entered in here it is assumed you will require membership of PDMC or GPMC)
Nationality
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 (If no club is entered in here it is assumed you will require membership of PDMC or GPMC)
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
Forced Induction / Rotary
Four Wheel Drive
Class
In Car Camera Request
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
Motorsport News Circuit Rally Championship
Crew Members Registered
Driver Championship Registration Number
Co-Driver Championship Registration Number
MSN Rally Champ Michelin Cup Competitor
Crew Members Registered
Driver Championship Registration Number
Co-Driver Championship Registration Number
ANWCC Stage Rally Championsip
Crew Members Registered
Driver Championship Registration Number
Co-Driver Championship Registration Number
SD34 MSG Stage Rally Championship
Crew Members Registered
Driver Championship Registration Number
Co-Driver Championship Registration Number
ANCC Stage 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 85 entries, where do you think you should be seeded?
Scrutineering
Saturday scrutineering is as the Final Instructions

 

Sunday morning scrutineering is STRICTLY by appointment and must be requested in writing to the entries secretary

Saturday
Sunday (By written appointment only places limited)
Fees - see above for how to pay
Entry Fee £
Club Membership (Please Select) £
Sorry Sold Out

Garage (allocated on first come first served basis - max 22 (single car units, available) + 5 reserves)

 

 

1 car unit is £60,2 car unit is £120

Fees to be paid with entry

 

 

£
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

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, 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. 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.."

If you have selected a garage you agree to be bound by the terms and conditions of use set out by Bordogan Estates (Anglesey Circuit) 

You also understand that Motorsport News Circuit Rally Competitors will be given priority of entry.

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