Somerset Stages Rally 2017 Internet Entry Form

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

Welcome to the Somerset Stages Rally 2017 On-line Entry Form.

Please complete all the fields in the form below. The fields with red backgrounds are mandatory. Once you have clicked on the "Enter the Rally" button at the end of the form you will receive an automated email confirming we have received your entry form and with details of how to pay for your entry (either by Bank Transfer, Cheque or Paypal (4% fee added to cover Paypal costs).

All the fields with a red background must be filled in, or you will not be able to continue. Please put TBC in any red field which you do not know the details for.

Please provide any missing information or advise any changes by e-mail as soon as you are aware of them and as far as possible prior to arriving at the event.

‘Held under the General Regulations of The Motor Sports Association (incorporating the provisions of the International Sporting Code of the FIA) and the Event's Supplementary Regulations.’

Document Addressing
E-Mail address for communication
Real Name of this person
Who should we email/send Finals to?
Driver
Full Name
Address
Post Code
Home Town (Important for Media)
Telephone Number
Mobile Number
Competition Licence Number
Competition Licence Issuer & grade
E-Mail Address
Club
Date of Birth
Nationality
Driver & Car Commentary Info
Profession?
How Long Rallying?
History of car & any notable results?
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 (Important for Media)
Telephone Number
Mobile Number
Competition Licence Number
Competition Licence Issuer & Grade
E-Mail Address
Club
Date of Birth
Nationality
Co-Driver Publicity
Profession?
How Long Rallying?
Any other information the commentator can use about you, the driver or the car....
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 engine
Four Wheel Drive
Class
In Car Camera Request?
FIA Homologated ? Yes / No
Insurers (if not using Event scheme)
Insurer & Policy No.
Address.
Service Vehicle Details
Service Vehicle Size
If you wish to service with another crew please tell us their name(s) so we can try and allocate you to the same service area;
Championships
RAVENOL BTRDA Gold Star Championship
Crew Members Registered
RAVENOL BTRDA Silver Star Championship
Crew Members Registered
The THOMAS PANELS BTRDA 1400 Rally Championship
Crew Members Registered
BTRDA Rally First Championship
Crew Members Registered
BTRDA Historic Cup
Crew Members Registered
MG ZR Rally Challenge 2017
Crew Members Registered
Fiesta ST Challenge
Crew Members Registered
MAXXIS Tyres MSA English Rally Championship
Crew Members Registered
ASWMC REIS Loose Surface Stage Rally Championship
Crew Members Registered
BTRDA Production Cup
Crew Members Registered
FMP Rally Challenge
Crew Members Registered
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?
Fees - see above for how to pay
Entry Fee £
Insurance £
Management Pack£
Sponsor a Marshal£
Total Money to be sent£
How will you pay? (Bank Transfer / Cheque / Paypal)
Entrant (only complete if a 2017 MSA entrants licence is held)
Name
Address
Post Code
Telephone Number
Competition Licence Number

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. Please make your payment as soon as possible.

Please provide any missing information or advise any changes by e-mail as soon as you are aware of them and as far as possible prior to arriving at the event.

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.."

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