Red Dragon IT Stage Rally (EMCOS) 27 May 2017 Internet Entry Form

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

If you enter and pay by 23.59 on 30th April the Entry Fee is £215, from May 1st the entry fee will be £235

Entries Secretary: Connie Leyfield

Telephone 01285 670749 / 07837056148
E-mail: emcosrally@emcos.co.uk

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

Welcome to the Red Dragon IT Stages 2017 Online Entry system. Please follow the steps below to enter the rally.

  1. Complete at least the RED MANDATORY fields in the form below and as much other information as possible. The fields with a red background are mandatory and must be filled in or you will not be able to continue. Enter TBA in any mandatory fields for which you do not know the details.  Please submit any corrections or missing information to emcosrally@emcos.co.uk as soon as possible.
  2. Once you have completed the form, hit the "Enter the Event" button and you will be directed to the payment screen displaying the payment options.  You will also receive a confirmation email.
  3. If paying by BACS the EMCOS account details are: Sort Code 30-98-29 account number 03710989.   Please use Drivers initials and surname as reference.
  4. Payment can no longer be made by PayPal
  5. If paying by cheque please make it out to 'EMCOS LTD' and send it to the Entry secretary, RDIT EMCOS, Connie Leyfield, 2 North Home Road Cirencester, Glos.  GL7 1DP.
  6. If paying by cash please call the Connie the Entry Sec on 01285 670749 / 07837056148 between 18:00-21:00 to arrange delivery by hand. Cash Payments must be made prior to entires closing on 24th May.
  7. WITHOUT PAYMENT YOUR ENTRY WILL NOT BE VALID.
  8. Expect a response to online entries within 3 days and within 7 days if sent by post.  If you have any queries please e-mail emcosrally@emcos.co.uk or call 01285 670749 between 18:00-21:00. 
  9. To be included in seeding, we must have received your entry by 18th May at 18:00.
  10. Entries close on 24th May
  11. If you enter and pay by 29.59 on 30th April the Entry Fee is £215, from May 1st the entry fee will be £235

Competitors under the age of 18 will require the signature of their parent or guardian as Guarantor. A Guarantor is expected to attend the event and sign-on as an entrant. If they are unable to be present a representative can attend but must produce the Guarantor's written and signed authorisation to act on their behalf.

All the data entered on this page will be stored on a computer for the purposes of administering the entries for the Red Dragon IT Stages 2016 and will not be passed to any third parties.

Document Addressing
E-Mail address for communication
Real Name of this person
Whom should we send Finals and Results to?
How would you like to receive Finals and Results?
Driver
Full Name
Address
Post Code
Home Town
Home telephone Number
Mobile Number
Competition Licence Number
Grade of Licence
E-Mail Address
Club - See article 4.1 for club eligibity
Date of Birth (if under 18).
Nationality
Driver Publicity
How Long Rallying?
Notable Results
Driver's Parent or Guardian (under 18 only)
Name
Address (if different)
Post Code
Primary Telephone Number
Relationship
Co-Driver
Full Name
Address
Post Code
Home Town
Home Telephone Number
Mobile Number
Competition Licence Number
Grade of Licence.
E-Mail Address
Club - Club - See article 4.1 for club eligibity
Date of Birth (if under 18).
Nationality
Co-Driver Publicity
How Long Rallying?
Notable Results
Co-Driver's Parent or Guardian (under 18 only)
Name
Address (if different)
Post Code
Primary Telephone Number
Relationship
Car
Make
Model
Colour
Registration Number
Engine Capacity
Year
Forced Induction
Four Wheel Drive
Class
Service vehicle details
Make (Extra large service vehicles by prior arrangement only, SR 18.1 )
Registration 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
Cotswold Motor Sport Group
Crew Members Registered
Driver Championship Registration Number
Co-Driver Championship Registration Number
Heart of England 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 PositionClass Position
Seeding - Competitor Opinion
Out of 85 entries, where do you think you should be seeded?
Fees - Payable by BACS, Cheque or Cash.  Details at top of form.
Entry Fee £
Club Membership £
Donation to the Club's Marshal fund.£
Total Money to be sent£
Payment Method
Entrant (if applicable and not driver)
Name
Address
Post Code
Telephone Number
Nationality
Competition Licence Number
Competition Licence Issuer
Comments

Extra comments you feel might be relevant for seeding or about your entry

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 and competent to take part in the event. I understand that motorsport is dangerous and accidents causing death, injury, disability and property damage can and do happen. I understand that these risks may give rise to my suffering personal injury or other loss and I acknowledge and accept these risks. 
2) To the best of my belief the driver(s) possess(es) the standard of competence necessary for an event of the type to which this entry relates and that the vehicle entered is suitable and roadworthy for the event having regard to the course and the speeds which will be reached. 
3) The use of the vehicle hereby entered is covered by insurance as required by the law which is valid for such part of this event as shall take place on roads as defined by the law. 
4) 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 which has, following such declaration, issued a licence which permits me to do so. 
5) 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/legal guardian/guarantor, whose full names and addresses have been given. 
6) 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/Guardian/Guarantor I 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 Part 3, Appendix 1. Note: Where the Parent/Guardian/Guarantor 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. 
7) I hereby agree to abide by the MSA Child Safeguarding Policy and Guidelines and the National Sporting Code of Conduct. 
8) 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. (H10.1.6) 
9) I have read and fully understood the Procedure for Control of Drugs and Alcohol as contained in the MSA Yearbook Regulations H39, D35.1, G15.1.4 and have also fully familiarised myself with the information on the web sites referred to (www.ukad.org.uk and www.wada-ama.org) in particular the UK Anti-Doping Rules which have been adopted by the MSA. Further, if I am counter-signing as the Parent or Guardian of a minor then in addition to the deemed consent to the testing of that minor (Art 5.6.2) I hereby confirm that I give such consent for the minor concerned to be so tested. Indemnity: In consideration of the acceptance of this entry I agree that neither any one of or any combination of the MSA and its associated clubs, the organisers, the land owners or other occupiers, the promoters and their respective officers, servants, representatives and agents (the “Parties”) shall have any liability for loss or damage which may be sustained or incurred by me as a result of participation in this event. Nothing in this clause is intended to or shall be deemed to exclude or limit liability for death or personal injury. To the fullest extent permitted by law I agree to indemnify and hold harmless each of the Parties in respect of any loss or damage whatsoever and howsoever arising from my participation in this event.

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