Document Addressing E-Mail address for communication Real Name of this person Whom should we send Finals and Results to? Driver Co-DriverDriver 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 No YesClass B1/B2 - Category 1 - registered before 31/12/1967 - Cars up to 1000cc and Cars 1001cc to 1300cc B3 - Category 1 - registered before 31/12/1967 - Cars 1301cc to 1600cc, excluding Twin Cam engine cars B4 - Category 1 - registered before 31/12/1967 - Cars over 1601cc, including Twin Cam engine cars B5 - Category 1 - registered before 31/12/1967 - Cars over 2000cc, including all Porsche 911s C1/C2 - Category 2 - registered between 01/01/1968 and 31/12/1974 - Cars up to 1300cc and Cars 1301cc to 1600cc, including 2 value Twin Cam engine cars C3 - Category 2 - registered between 01/01/1968 and 31/12/1974 - Cars 1601cc to 2000cc C4/C5 - Category 2 - registered between 01/01/1968 and 31/12/1974 - Cars over 2000cc, including all Multi-value Twin Cam engine cars D1/D2 - Category 3 - registered between 01/01/1975 and 31/12/1981 - Cars up to 1300cc and Cars 1301cc to 1600cc, including 2 value twin cam engines D3 - Category 3 - registered between 01/01/1975 and 31/12/1981 - Cars 1601cc to 2000cc D4 - Category 3 - registered between 01/01/1975 and 31/12/1981 - Cars (including Twin Cam Multi-value engine cars) over 2000cc D5 - Category 3 - registered between 01/01/1975 and 31/12/1981 - All other Twin Cam Multi-value engine cars E1 - Category 4a - registered between 01/01/1982 and 31/12/1985 - Cars up to 1600cc E2 - Category 4a - registered between 01/01/1982 and 31/12/1985 - Cars over 1601cc F1 - Category 4b - registered between 01/01/1986 and 31/12/1990 - Cars up to 1600cc F2 - Category 4b - registered between 01/01/1986 and 31/12/1990 - Cars over 1601cc G1 - Category K - FIA Appendix K Cars registered before 31/12/1985 - Cars up to 1600cc G2 - Category K - FIA Appendix K Cars registered before 31/12/1985 - Cars over to 1601cc T14 - Rally2 Challenge - Cars up to 1400cc, complying with MSA Regulations and Tyro Specification T16 - Rally2 Challenge - Cars up to 1601cc, complying with MSA Regulations and Tyro Specification One-Four - Rally2 Challenge - Cars up to 1400cc, complying with MSA Regulations Open - Rally2 Challenge - Cars 1401cc to 2000cc, complying with MSA Regulations (including FIA R2/R2T) Open-Plus - Rally2 Challenge - Cars over 2001cc, complying with MSA Regulations (including FIA R3/R3T) M1 - Cars conforming to 2017 MSA Technical Regulations. All cars must have a valid MSA Competition Car Logbook (CCLB) - Cars up to 1400cc (two wheel drive only) (National B Modern) M2 - Cars conforming to 2017 MSA Technical Regulations. All cars must have a valid MSA Competition Car Logbook (CCLB) - Cars 1401cc to 1600cc (two wheel drive only) (National B Modern) M3 - Cars conforming to 2017 MSA Technical Regulations. All cars must have a valid MSA Competition Car Logbook (CCLB) - Cars 1601cc to 2000cc (two wheel drive only) (National B Modern) M4 - Cars conforming to 2017 MSA Technical Regulations. All cars must have a valid MSA Competition Car Logbook (CCLB) - Cars over 2001cc (two wheel drive only) (National B Modern)In Car Camera Request Insurers Name Address Service Vehicle Type of Vehicle
(please indicate make and model in the fields below) Car 4x4 Pick-up SWB Van LWB Van Motorhome OtherMake (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 None Driver Co-Driver BothDriver Championship Registration Number Co-Driver Championship Registration Number Motorscope Northern Historic Rally Championship Crew Members Registered None Driver Co-Driver BothDriver Championship Registration Number Co-Driver Championship Registration Number Rally2 Challenge Crew Members Registered None Driver Co-Driver BothDriver 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 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 20:00Fees - see above for how to pay Entry Fee £599.00 - Historic Section 798.00 - Historic Section + National B Two 1198.00 - Historic Section + National B Five Insurance £0.00 25.00 - Insurance Fee Guest/Sponsor Access Passes £0.00 50.00 Motorhome Plate £0.00 100.00 Colour Rally Map Book £0.00 - None 25.00 - One 50.00 - Two 75.00 - Three Marshals' Fund £ Richard Burns Foundation Donation £5.00 10.00 15.00 20.00 25.00 30.00 35.00 40.00 45.00 50.00 0.00 Full Colour Souvenir Programme £0.00 - None 4.00 - One 8.00 - Two 12.00 - Three 16.00 - Four Total Money to be sent £ Payment Method and Details Internet bankingEntrant (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).
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.
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.