Rali Mike Darowen Bro Ddyfi 2018 Internet Entry Form

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

Rali Mike Darowen Bro Ddyfi 2018

M L Evans Darowen Ltd 

Dovey Valley Motorclub

Document Addressing
E-Mail address for communication
Real Name of this person
Driver
Full Name
Address
Post Code
Mobile Number
Telephone Number
Competition Licence Number
E-Mail Address
Club
Date of Birth
Driver's Parent or Guardian (under 18 only)
Name
Address (if different)
Post Code
Telephone Number
Relationship
Navigator
Full Name
Address
Post Code
Mobile Number
Telephone Number
Competition Licence Number
E-Mail Address
Club
Date of Birth
Navigator's Parent or Guardian (under 18 only)
Name
Address (if different)
Post Code
Telephone Number
Relationship
Car
Make
Model
Colour
Registration Number
Engine Capacity
Class
Insurers
Name
Address
Championships
Welsh Association Motor Clubs Road Rally Championship
Crew Members Registered
Driver Championship Registration Number
Navigator Championship Registration Number
Association of North Western Car Clubs Road Rally Championship
Crew Members Registered
Driver Championship Registration Number
Navigator Championship Registration Number
Association of North Western Car Clubs All-rounder Championship
Crew Members Registered
Driver Championship Registration Number
Navigator Championship Registration Number
Association of North Western Car Clubs Ladies Rally Championship
Crew Members Registered
Driver Championship Registration Number
Navigator Championship Registration Number
Welsh Border Car Club Road Rally Championship
Crew Members Registered
Driver Championship Registration Number
Navigator Championship Registration Number
Eligible for Under 1425cc Award
Crew Members Registered
Driver Championship Registration Number
Navigator Championship Registration Number
Eligible for Mixed Crew Award
Crew Members Registered
Driver Championship Registration Number
Navigator Championship Registration Number
Eligible for Veteran Crew Award
Crew Members Registered
Driver Championship Registration Number
Navigator Championship Registration Number
Best DVMC Crew Award
Crew Members Registered
Driver Championship Registration Number
Navigator 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 Navigator
Name
Address
Post Code
Telephone Number
Relationship
Will this person be attending the event?
Seeding - Past Performance on Rallies
Event Name and ClubYearTypeOverall PositionNo of Starters
Seeding - Competitor Opinion
Out of 50 entries, where do you think you should be seeded?
Fees
Entry Fee £
Club Membership £
Insurance
Please ensure you refer to SR.22 before completing insurance 		£
MSA License Application£
Total Money to be sent£
Payment Method and Details- BACS payment or Cheque. NB if paying by cheque please make cheques payable to "DVMC" and post to entries secretary within 24 hrs of submitting entry form.

 

Bank account details are:

Dovey Valley MC Ltd

Nat West

Sort Code: 53-81-26

Account number: 3643 8413

Marshal Details
Name
Address
Post Code
Mobile Number
Telephone 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.

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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