Horiba D'Isis Stages Rally 2018 Internet Entry Form

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

Entries Close online 24th April 2018 at 23.59.

Last date for normal entries 17th April at 6pm

Entries Secretary: Mark Colston
61 Brownley Road
Shirley
Solihull
West Midlands
B90 4QP
Phone 0121 243 5392 or 07540 765830 (Between 6pm and 9pm only)

e-mail entries@disis-stages.org.uk

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 Horiba D'Isis Stages Rally 2018 On-line Entry system. 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. 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.
  3. There are then three ways to pay
    1. The easiest and cheapest way to pay is on-line by bank transfer. If you have internet or telephone banking, you can arrange for the fees to be paid directly into our account. You need to pay £100 now, with the balance payable no later than the 17th April. The details are:-
      Bank Santander
      Sort Code 09-01-54
      Account No. 23754009
      Account Name Quinton Motor Club Ltd
      Reference Driver's full name & Car Reg.
    2. If you would like to pay via credit or debit card, please use the link shown after you submit your entry to take you to Paypal's website, where you can pay for your entry by card. Note that we do not see your card details at all, this is all handled for us by Paypal. 
    3. You can send a cheque, or 2 cheques if paying in installments, made payable to 'Quinton Motor Club Ltd' to the Entries Secretary at the address above. One should be for £100 which will be banked on receipt, the second for the balance, which will be banked on the 17th April.
  4. Within 24 hours of us receiving the payment for your entry you should receive an e-mail confirming your entry from the Entries Secretary. NOTE: WITHOUT THE MINIMUM PAYMENT BEFORE 17th APRIL AND FULL PAYMENT BY 17th APRIL, YOUR ENTRY WILL NOT BE VALID. This means other competitors who are later entries, but have complied with these conditions may take precedence over your entry and you could be considered as reserve.
  5. 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 entries@disis-stages.org.uk

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 at this time, but follow up with the details ASAP.

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.

Document Addressing
E-Mail address for communication
Real Name of this person
Driver
Full Name
Address
Post Code
Home Town
Telephone Number
Mobile Number
Competition Licence Number
E-Mail Address
Club
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
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
FIA Fuel?
Forced Induction
Four Wheel Drive
Class
In Car Camera Request
Service Vehicle
Make
Model
Colour
Registration Number
Contact Name
Contact 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
Association of West Midlands Motor Clubs
Crew Members Registered
Driver Championship Registration Number
Co-Driver Championship Registration Number
The Association of North Western Car Clubs
Crew Members Registered
Driver Championship Registration Number
Co-Driver Championship Registration Number
East Midlands Association of Motor Clubs Single Venue
Crew Members Registered
Driver Championship Registration Number
Co-Driver Championship Registration Number
Association Of Central Southern Motor Clubs
Crew Members Registered
Driver Championship Registration Number
Co-Driver Championship Registration Number
Person to be contacted in case of serious accident to Driver, who must not be the other crew member.
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, who must not be the other crew member.
Name
Address
Post Code
Telephone Number
Relationship
Will this person be attending the event?
Seeding - Past Performance on Rallies
Event Name and ClubYearTypeSurfaceOverall PositionNo of Starters
Seeding - Competitor Opinion
Out of 80 entries, where do you think you should be seeded?
Scrutineering
Choose Friday or Saturday Scrutineering (not both) Friday 18:00 to 20:00 hours
Saturday 07:15 to 09:00 hours.
Would you like Friday Night Parking?
Fees - see above for how to pay
Entry Fee £
Club Membership £
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
Competition Licence Issuer
Comments
Anything else you'd like to tell us

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.

INDEMNITIES AND DECLARATIONS 

All indemnities will be available at event signing on and must be signed prior to the competitor being allowed to start.

 

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