The Holrus Targa Rally 2018 Internet Entry Form

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

Entries Close for seeding on Saturday the 7th of July 2018 at 10.00 pm

Entries Secretary: Amy Horn
Cefn Coed, Bettws Cedewain, Newtown, Powys SY16 3LQ

Telephone 07983 636707

E-mail: holrusentries@outlook.com

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 Holrus Targa Rally Online Entry system

Sponsored by C&L 24 Hour Emergency Drainage

Please follow the steps below to enter the rally. Ensure you read the Supplementary Regulations carefully. You are drawn to page 5 where it states: The first 25 fully completed entry forms will guarantee an entry and the organisers reserve the right to retain 25 places to allocate at their discretion.

Complete all the fields in the form below. The fields with red backgrounds are mandatory.

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.

Entry fee is £100.00 which will include a donation to Hope House Hospice, drink and hog roast for competing crew at the finish.

There are then two ways to pay.If you have internet or telephone banking, you can arrange for the fees to be paid directly into our account.

Details are:


Sort Code	40 34 33
Account No.	61051903
Account Name	NADAC Ltd
Reference	Driver's Name

Cheque made payable to NADAC to the Entries Secretary at the address above

No Cheque entries accepted after 7th July 2018. However, you are strongly advised to pay via BACS rather than waiting for a cheque to clear if you are keen for an entry!

Post dated cheques are not accepted.

****Please be aware that your entry will not be accepted UNTIL PAYMENT IN FULL HAS BEEN RECEIVED and cleared.****

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 holrusentries@outlook.com

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 (but send them as soon as you do!!)

Document Addressing

E-Mail address for communication

Real Name of this person

Whom should we send Finals and Results to?

Driver
Co-Driver

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

Class

E - Expert
SE - Semi-Expert
N - Novice

Insurers

Name

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?

Yes
No

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?

Yes
No

Seeding - Past Performance on Rallies

Event Name and Club	Year	Type	Overall Position	No of Starters

Fees - see above for how to pay

Entry Fee

Club Membership

Insurance

Total Money to be sent

Payment Method and Details

Marshal Details

Name

Address

Post Code

Telephone Number

Mobile Number

Email Address

Experience

Comments

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.

We would also like to be allowed to contact you in the future to tell you about other events which we are running, including this event in future years. If you are happy to allow us to do this, please say so here.

No
Yes

We would also like to be allowed to pass on your Name, Address, Post Code and email addresses to [INSERT VIDEO COMPANY HERE] and [INSERT PHOTO COMPANY HERE] so that they can contact you with a view to offering you videos and photos of you on the event. If you are happy to allow us to do this, please say so here.

No
Yes

Remember your entry is subject to receipt of the correct entry fee and all requested information. 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 consent to the organising committee using the information I have given for the purpose of displaying relevant details on an entry list to be made available to the public via written and electronic means, and for mailings to promote future editions of any NADAC events. The information provided will be treated in confidence and will be held in compliance with the Data Protection Act 1998. Crews personal details will be shared with members of the Rally and Ludlow Castle Motor Club Committees and address labels/email addresses for the purposes of distributing Press Releases and advertising their services. I undertand you cannot verify that the Official Photographers/Media will not share such information with other organisations or individuals.

MSA Indemnity

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

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. 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.
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.
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.
I understand that should I, at the time of this event, be suffering from any disability whether permanent or temporary which is like 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.
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.
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. NB. 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.
I hereby agree to abide by the MSA Child Protection Policy and Guidelines and the National Sporting Code of Conduct.
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).
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, G15.1.14 and have also familiarised myself with the information on the websites 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 (as amended). Further, if i am countersigning at 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.

In consideration of the acceptance of this entry, I agree that neither any one or of 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.

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