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Neil Howard Stages in association with G Coffey Solicitors 2017 Internet Entry Form

Neil Howard Stages

In Association With

Graham Coffey Solicitors 2017

WWW.NHSTAGES.BLMCC.CO.UK

#nhstages

  

Welcome to the Neil Howard Stages in association with Graham Coffey Solicitors 2017

With a number of event improvements from 2016 for Bolton-Le-Moors Car Club together with being round 1 of the third year of the Motorsport News Circuit Rally Championship in association with MSVR, we are sure you will really enjoy this years rally.

 

Entries Open 8th September 2017 @ 20:00 at the rate of £295.00

Entries Close for seeding on 27th October 2017 @ 23:59 

Entry Tickets emailed to fully paid entries - W/C 29th October 2017

**NOTE - Prioirity of entry will be given to Motorsport News Circuit Rally Championship competiors for the first 24 hours **

Entries Secretary: Jack Mather

11 Lupin Close

Whittle-le-Woods

Chorley

Lancashire

PR6 7RG


Telephone 07568 555242 (Between 19:00 and 23:00)

e-mail: entries@blmcc.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 "Neil Howard Stages in association with Graham Coffey Solicitors 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 - boltonlemoors@gmail.com - to use this option a charge of 4.35% is made by the club, to cover fees.
    2. Cheque (To the entry secretaries address payable to Bolton-Le-Moors Car Club Ltd)
    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 Santander
      Sort Code 09-01-50
      Account No. 04373782
      Account Name BOLTON LE MOORS CAR CLUB LTD
      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).
  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 Jack entries@blmcc.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 BLMCC)
Nationality
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 (If no club is entered in here it is assumed you will require membership of BLMCC)
Nationality
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
Forced Induction / Rotary
Four Wheel Drive
Class
In Car Camera Request
Sponsor
Sponsor Name (Note: this sponsor does not need an entrant's licence)

Did you know your sponsor could advertise in the official event programme from as little as £100.  Please contact Blmcc Media for details. media@blmcc.co.uk
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
MSN Rally Champ Protyre Challenge Competitor
Crew Members Registered
Driver Championship Registration Number
Co-Driver Championship Registration Number
MSN Rally Champ Hockly Swift 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
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 95 entries, where do you think you should be seeded? Please enter a exact number as entering a range or leaving blank makes seeding more difficult
Scrutineering
When would you prefer to scrutineer? - Note Saturday slots are limited and allocated on a first requested basis Friday
Saturday (First come first served places limited)
Fees - see above for how to pay
Entry Fee £
Club Membership (Please Select) £
Garage (allocated on first come first served basis - max 28 available + 5 reserves) - Sorry Sold Out
 
£
Donation to the Marshals Fund (Please Select)£
Donation to Headway (Please Select)£
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 Motorsport Vision (MSV) clearly displayed in a prominent position on the garage.  These terms are available in advance on request.

I also understand that Motorsport News Circuit Rally Championship Competitors will be given priority of entry for the first 24 hours.

Web Entries System provided by rallies.info