Cambrian Targa Rally 2018 Internet Entry Form

Entries Close at midnight on Wednesday 7th November 2018

 

Alison Jones

Llwyn Aur

New Cross

Aberystwyth

Ceredigion

SY23 4LZ

Telephone: 01974 261645

e-mail: karen_gti_1@hotmail.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 Tregaron and District Motor Club Cambrian Targa Online Entry system.

PLEASE ENSURE YOU HAVE READ THROUGH THE REGULATIONS BEFORE YOU COMPLETE THE ENTRY FORM

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 check that you have entered the correct e-mail address.
  3. 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.
  4. Without payment your entry will not be valid.
  5. There are 2 payment methods:
    1. BACS (Bank transfer to Tregaron & District Motor Club, Barclays Bank SORT CODE: 20-18-41 ACCOUNT NUMBER: 40455989 YOU MUST STATE DRIVER & NAVIGATOR NAME ON THE TRANSFER SO WE CAN LINK IT TO YOUR ENTRY
    2. CHEQUE, made payable to 'Tregaron & District Motor Club' to posted to the Entries Secretary at the address above (your entry will not be confirmed until the cheque has cleared) YOU MUST STATE DRIVER & NAVIGATOR NAME ON THE BACK OF THE CHEQUE SO WE CAN LINK IT TO YOUR ENTRY
  6. Within 2 days of us receiving cleared payment for your entry you should receive an e-mail confirming your entry from the Entries Secretary.
  7. If you don't receive a response within 3 days of the expected payment date, or if you have any other questions, please e-mail karen_gti_1@hotmail.com

If you are unsure of certain details such Navigators name please enter TBA in the field which is red and send updated details AS SOON AS POSSIBLE to karen_gti_1@hotmail.com

IF YOU INTEND TO PAY FOR JELF INSURANCE ON THE DAY- PUT ON THE DAY JELF  (in the insurers- NAME column) and own insurance 0:00 in fees column

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

Document Addressing
E-Mail address for communication
Real Name of this person
Driver
Full Name
Address
Post Code
Telephone Number
Mobile Number
E-Mail Address
Date of Birth
Driver's Parent or Guardian (under 18 only)
Name
Address (if different)
Post Code
Telephone Number
Relationship
Co-Driver
Full Name
Address
Post Code
Telephone Number
Mobile Number
E-Mail Address
Date of Birth
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
Four Wheel Drive
Class
Insurers
Name & policy No
Address
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 ClubYearOverall Position
Fees - see above for how to pay
Entry Fee £90.00 £
Club Membership £
Insurance £
Total Money to be sent£
Payment Method and Details
Privacy and Permissions

We take your privacy seriously and will only use your personal information to administer your entry, including providing a public Entry List and sending you emails in connection with your entry. Some of your information will be passed on to the organisation providing results for the event (Rally Roots), the MSA and Jelf the insurance provider.

We would also like permission to contact you in the future to let you know about other events which we are running, including this event in future years. If you are happy to allow us to do so, please confirm here

We would also like to be allowed to pass on your email addresses to the official photographer so that they can contact you with a view to offering photos of you on the event. If you are happy to allow us to do this, please confirm here

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:-

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 any event in 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 Royal Automobile Club Motor Sports Association Ltd 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/co-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 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 Competitors’ and Officials’ Yearbook Regulations H39, D35.1, G15.1.4 and have also familiarised myself with the information on the websites referred to (www.ukad.org.ukand www.wada-ama.org) in particular the UK Anti Doping Rules which have been adopted by the MSA (as amended).  Further, if I am counter-signing as the Parent/Guardian/Guarantor 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 the 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.

I declare that the information given on this entry form is a correct statement of facts as verified by me.

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