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Pirelli International Rally 2018 (Historic Section) Internet Entry Form

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

Entries Close for seeding on Saturday 14th April 2018 at midnight

Entries Secretary:

Lynne Cooke

Brantridge
Portinscale
Keswick
CA12 5RW

Telephone: 01768 771219  before 9pm only
E-mail: entries@pirelliinternationalrally.co.uk

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

Welcome to Pirelli International 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 is only one way to pay:
    If you have internet or telephone banking, you can arrange for the fees to be paid directly into our account. The details are:-
    Bank HSBC    
    Sort Code 40-16-22 International Bank Account Number (IBAN) GB78HBUK40162261204556
    Account No. 61204556  Branch Identifier Code (BIC) HBUKGB4113L
    Account Name Cumberland Sporting Car Club Ltd    
    Reference Driver's full name.    
  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 PAYMENT YOUR ENTRY WILL NOT BE VALID.
  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@pirelliinternationalrally.co.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.

If you want the finals Etc: to go to other than Driver/Co-Driver please ensure that name is the one in the Document Addressing below. Please note Finals will only be sent by email

Document Addressing
E-Mail address for communication
Real Name of this person
Whom should we send Finals and Results to?
Driver
Full Name
Address
Post Code
Home Town
Telephone Number
Mobile Number
Competition Licence Number
Competition Licence Issuer
E-Mail Address
Club
Place and Date of Birth
Nationality
Driver Publicity
Hobbies
Married?
No of Children
How Long Rallying?
Notable Results
Any other information
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
Competition Licence Issuer
E-Mail Address
Club
Place and Date of Birth
Nationality
Co-Driver Publicity
Hobbies
Married?
No of Children
How Long Rallying?
Notable Results
Any other information
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
Forced Induction
Class
In Car Camera Request
Insurers
Name
Address
Service Vehicle
Type of Vehicle
(please indicate make and model in the fields below)
Make (if known)
Model (if known)
Registration 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
FUCHS Lubricant MSA British Historic Rally Championship
Crew Members Registered
Driver Championship Registration Number
Co-Driver Championship Registration Number
Motorscope Northern Historic Rally Championship
Crew Members Registered
Driver Championship Registration Number
Co-Driver Championship Registration Number
Rally2 Challenge
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
Scrutineering
When would you prefer to scrutineer?
Friday 27th April 14:00 - 20:00
14:00 to 15:00
15:00 to 16:00
16:00 to 17.00
17:00 to 18:00
18:00 to 19:00
19:00 to 20:00
Fees - see above for how to pay
Entry Fee £
Insurance £
Guest/Sponsor Access Passes£
Motorhome Plate£
Colour Rally Map Book£
Marshals' Fund£
Richard Burns Foundation Donation£
Full Colour Souvenir Programme£
Total Money to be sent£
Payment Method and Details
Entrant (if applicable and not driver)
Name
Address
Post Code
Telephone Number
Competition Licence Number
Competition Licence Issuer

Service Area

Do you wish to service next to any other competitor(s) or do you have any particular service area needs?
Please note we will do our best to accommodate your service requests but it may not be possible for us to allocate you a service bay next to the requested competitor(s).

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.."

Note: 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.

 

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