Jack Neal Memorial Rally 2018 Internet Entry Form

Entries Close online 9th Feb 2018 at 0.00 after this time please email or phone the secretary

Secretary: 

Alex Harper.

07850100917     alexandramarie@hotmail.co.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 Jack Neal Memorial Rally Online 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 two ways to pay
    1. If you have internet or telephone banking, you can arrange for the fees to be paid directly into our account. The details are:-
      Bank Yorkshire Bank PLC
      Sort Code  05-03-78
      Account No.  39082398
      Account Name Clitheroe and District Motor Club
      Reference Driver's full name.
    2. You can send a cheque made payable to 'Clitheroe & District Motor Club' to the Entries Secretary at the address above. Entries after 5th Feb 2018 must either be BACS or CASH (no cheques).
  4. As soon as possible after receiving the payment for your entry you should receive an e-mail confirming your entry from the Entries Secretary. NOTE: WITHOUT PAYMENT YOUR ENTRY WILL NOT BE VALID.
  5. If you do not receive a response within 3 days of the expected payment date, or if you have any other questions, please e-mail alexandramarie@hotmail.com
  6. 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.
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
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
The Association of North East 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
The SD34 MSG Stage Rally Championship
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
GwynneSpeed
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?
Seeding - Past Performance on Rallies
Event Name and ClubYearTypeSurfaceOverall PositionNo of Starters
Seeding - Competitor Opinion
Out of 50 entries, where do you think you should be seeded?
Scrutineering
Choose Friday or Saturday  Scrutineering (not both) Friday 17:30 to 19:30 hours
Saturday 7:00 to 08.30 hours.
Fees - see above for how to pay
Entry Fee £
Club Membership £
Marshals' Support Fund£
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
Marshal Details
Name
Address
Post Code
Telephone Number
Mobile Number
Email Address
Experience

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.

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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