Melvyn Evans Motorsport Tour of Epynt 2018 Internet Entry Form

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

MELVYN EVANS MOTORSPORT TOUR OF EPYNT 2018

Sunday 11th March 2018

Entries Close for seeding on Wednesday 7th March 2018

Entries Secretary:

Mr Robert Wilson 
37 Maes Y Wawr
Birchgrove
Swansea
SA7 0HL


Telephone 01792 700299 (5pm - 9pm)

e-mail: rallyentry@gmail.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 Melvyn Evans Motorsport Tour of Epynt 2018 Online Entry System. Please follow the steps below to enter the rally.

IF COMPLETING BACS PAYMENT PLEASE PUT DRIVER/CO-DRIVER NAME IN 'REFERENCE.'

IF PAYING BY CHEQUE PLEASE PUT 'DRIVER AND NAVIGATOR NAMES' ON REAR OF CHEQUE!

  1. Complete all the fields in the form below. The fields with red backgrounds are mandatory. Please put TBA in any red field which you do not know the details for and inform the entries secretary via email as soon as the information is known.
  2. There are two ways to pay: If you have internet or telephone banking, you can arrange for the fees to be paid directly into the club's account.
  3. Or, you can send a cheque made payable to 'Port Talbot Motor Club Ltd' to the Entries Secretary at the address above. Your payment will be expected within 5 working days of entry, if there are issues regarding payment i.e. away with work, on holiday or awaiting payday please inform the entry secretary via email rallyentry@gmail.com . NOTE: WITHOUT PAYMENT YOUR ENTRY WILL NOT BE VALID. In the case of over subscription entries paid in full take priority. 
  4. 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.
  5. Bank Barclays
    Sort Code 20-84-41
    Account No. 40750743
    Account Name Port Talbot Motor Club Ltd     
    Reference Driver's full name.

 

Document Addressing
E-Mail address for communication
Real Name of this person
Whom should we send Finals and Results to?
Driver
Full Name
Address
Post Code
Telephone Number
Mobile Number
Competition Licence Number
E-Mail Address
Club
Date of Birth of driver if under 21 years old
Is this the Driver's 1st time on Epynt as a Driver?
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
Competition Licence Number
E-Mail Address
Club
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
Forced Induction
Four Wheel Drive
Class
Own Insurers (If NOT using JELF event insurance)
Name
Address
Championships
Protyre MSA Asphalt Championship
Crew Members Registered
Driver Championship Registration Number
Co-Driver Championship Registration Number
JD Tyres Welsh National Tarmacadam Championship
Crew Members Registered
Driver Championship Registration Number
Co-Driver Championship Registration Number
Hirefit King of Epynt Challenge
Crew Members Registered
Driver Championship Registration Number
Co-Driver Championship Registration Number
FMP Rally Challenge
Crew Members Registered
Driver Championship Registration Number
Co-Driver Championship Registration Number
ANWCC Stage Rally Championship
Crew Members Registered
Driver Championship Registration Number
Co-Driver Championship Registration Number
WAMC Junior 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?
Drivers Seeding - Enter the best results achieved by the Driver ONLY (As a Driver, not as a Co-Driver), since 1st January 2011.
Event Name and ClubYearTypeSurfaceOverall Position

Position in Class

RECCE
Participating in Recce? (Details regarding Recce to be sent through with the Final Instructions).
Fees - see above for how to pay
Entry Fee £
Club Membership £
Insurance £
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
Comments

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.

I declare that I have been given the opportunity to read the General Regulations of the Motor Sport 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 cause 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.

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 track 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 however arising from my participation in the event.

I declare that 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 speed which will be reached.

I have read and fully understand 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 fully familiarised myself with the information on the web sites referred to (www.ukad.org.uk and www.wada-ama.org.uk ) on particular the UK anti Doping Rules which have been adopted by the MSA (as amended). 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 (UKAD Code Art 5.6.2) herby confirm that I give such consent for the minor concerned to be tested.

 

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