Raintite Coated Metals, Curzon Wealth Management Patriot Stages 2018 Internet Entry Form

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

Welcome to the Raintite Coated Metals, Curzon Wealth Management Patriot Stages 2018 On-line Entry Form.

Entries close for seeding on Thursday 20th September.
Entries finally close on Thursday 27th September at midnight.

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 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. Our preferred payment method is to pay by Bank Transfer, account name "Caerwent Rally".
    bank
    Please use DRIVERS SURNAME & CO DRIVERS SURNAME as reference.   If you are paying by cheque, please ensure that this is sent to the Entries Secretary at the address provided, made payable to "Caerwent Rally" and the crew members' names clearly written on the reverse                                                                                                   
  4. Within 72 hours of us 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 AND YOU WILL DROP TO THE BOTTOM OF THE LIST.
  5. If you do not receive a response within 5 days of the expected payment date, or if you have any other questions, please e-mail saunders.shirley@googlemail.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.

Thank you for your entry!

 
Document Addressing
E-Mail address for communication
Real Name of this person
Whom should we send Finals and Results to?
Driver
Full Name
Address
Contact Phone Number (preferably Mobile)
Competition Licence Number
E-Mail Address
Motor Club
Driver's Parent or Guardian (under 18 only)
Name
Address (if different)
Telephone Number
Relationship
Co-Driver
Full Name
Address
Contact Phone Number (preferably Mobile)
Competition Licence Number
E-Mail Address
Motor Club
Co-Driver's Parent or Guardian (under 18 only)
Name
Address (if different)
Telephone Number
Relationship
Car
Make
Model
Colour
Engine Capacity
Class (see article 8)
Championships
CMSG BP Motor Body Builders & Engineers Stage Rally Championship
Crew Members Registered
Driver Championship Registration Number
Co-Driver Championship Registration Number
Subaru WRC Spares Ltd ASWMC Stage Rally Championship 2018
Crew Members Registered
Driver Championship Registration Number
Co-Driver Championship Registration Number
FMP Rally Challenge 2018
Crew Members Registered
Driver Championship Registration Number
Co-Driver Championship Registration Number
AWMMC DMackTyres Heart of England Rally Championship
Crew Members Registered
Driver Championship Registration Number
Co-Driver Championship Registration Number
Junior F1000 Rally Challenge 2018
Crew Members Registered
Driver Championship Registration Number
Co-Driver Championship Registration Number
Person to be contacted in case of serious accident to Driver
Name
Telephone Number
Relationship
Will this person be attending the event?
Person to be contacted in case of serious accident to Co-Driver
Name
Telephone Number
Relationship
Will this person be attending the event?
Seeding - Past Performance on Rallies of Driver Only
Event NameYearSurfaceOverall PositionClass Position
Seeding - Competitor Opinion
Out of 100 entries, where do you think you should be seeded?
Scrutineering
When would you prefer to scrutineer? Saturday
Sunday
Fees - see above for how to pay
Entry Fee £
Club Membership £
Total Money to be sent£
Payment Method and Details
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 rallies which we are running, including this event in future years. If you are happy to allow us to do this, please say so here.

We would also like to be allowed to pass on your name and email addresses to EDP PhotoNews so that they can contact you with a view to offering you photos of you on the event. If you are happy to allow us to do this, please say so here.

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.

 I understand that should I at the time of this event be suffering from any disability whether permenent or temporary which is likely to affect prejudicially my normal control of my vehicle, I may not take part unless I have declared such disability to the ASN which has, following such decleration, issued a licence which permits me to do so.  

I declare that the use of the vehicle hereby enteredwill be covered by insurance by the law which is valid for such part of the event as shall take place on roads as defined by the law"

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