Rockingham Stages 2018 Internet Entry Form

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

Entries Close for seeding on 

SATURDAY 10th NOVEMBER

 (Final Entries Close at 11.30am. on Wednesday 28th NOVEMBER)

Entries Secretary: Tony Phillips

7 The Drive, Northwood, Middlesex, HA6 1HQ

Telephone 01923 822590 (Evenings before 9.30pm Only) or 07761 823157

e-mail: entries@rockinghamstages.co.uk

 

Held under the General Regulations of the Motor Sports Association (incorporating the International Sporting Code of the FISA)

and the Supplementary Regulations

The Rockingham Stages - 1/2nd December 2018

incorporating The  Rockingham Sunday Stages

Online Entry system.

Entry Fees:

Rockingham Stages -              Early Entry Fee - PAID by 10th November:     Class '0' £370, All Other Classes £395

                                                  Standard Entry Fee - 11th November to 17th November:                 All Classes  £415

                                                  Late Entry Fee - On or After 18th November:                                    All Classes  £475

Rockingham Sunday Stages -  Early Entry Fee - PAID by 10th November:   Class '0' £270, All Other Classes £295

                                                     Standard Entry Fee - 11th November to 17th November:                                  £315

                                                     Late Entry Fee - On or After 18th November                                                     £375

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 THREE 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:                         NatWest Bank, Thame

                Sort Code:                 60-21-21

                Account Number:      53518748

                Account Name:         Rockingham Stages

                Reference:                Driver's First Name and Surname        

            2. Send a cheque made payable to Rockingham Stages  to the Entries Secretary at the address above.

            3. Pay cash (or cheque) into any branch of NatWest Bank, to the Credit of Rockingham Stages (details as above). If using this method please advise the Entries Secretary (by post or email)

                  of the branch reference used.   

4.    PLEASE ENSURE YOU PUT THE DRIVERS NAME ON THE REVERSE OF THE CHEQUE FOR REFERENCE PURPOSES.

5.    Within 48 hours of us receiving the payment for your entry you should receive an e-mail confirming your entry from the Entries Secretary.

6.    NOTE: WITHOUT PAYMENT YOUR ENTRY WILL NOT BE VALID. IF PAYMENT IS NOT RECEIVED BEFORE 10th NOVEMBER (or 17th NOVEMBER), THE LATER FEE IS PAYABLE (Even if you subsequently cancel your entry).

7.    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@rockinghamstages.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.

Document Addressing
E-Mail address for communication
Real Name of this person
Whom should we send Finals and Results to?
Finals and Results will be sent by email.
Driver
Full Name
Address
Post Code
Telephone Number
Mobile Number
Competition Licence Number
E-Mail Address
Club
Age, if under 18 years
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
Telephone Number
Mobile Number
Competition Licence Number
E-Mail Address
Club
Age, if under 18 years
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
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 and Award Qualification
Hamilton Classic Ltd ACSMC Tarmacadam Rally Championship
Crew Members Registered
The jelfmotorsport.com AEMC/ASEMC Stage Rally Championship
Crew Members Registered
Mixed Crew
Crew Members Registered
Best Thame MC crew
Crew Members Registered
Best Middlesex County AC crew
Crew Members Registered
The Alexander Calder Financial EMAMC Rally Championship
Crew Members Registered
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 PositionClass Position
Seeding - Competitor Opinion
(Rockingham Stages Only) - Out of 90 entries, where do you think you should be seeded?

 

 

(Rockingham Sunday Stages Only) - Out of 30 entries, where do you think you should be seeded?

Scrutineering and Other Information
When would you prefer to scrutineer? (Rockingham Stages only)? Friday between 6.00pm and 8.00pm
Saturday between 7.30am and 10.45am
When would you prefer to scrutineer? (Rockingham Sunday Stages only)
I confirm that the driver is a UK taxpayer and wishes the charity to reclaim tax on the donation detailed. That person understands that they must pay Income and/or Capital Gains Tax in the tax year at least equal to the amount of tax that all the charities and Community Amateur Sports Clubs to which he (she) donates will reclaim on their gifts for that tax year. They also understand that other taxes such as Council Tax and VAT do not qualify and that the charity will reclaim 25p of tax on every £1 that is donated.
Fees - see above for how to pay
See Regulations or intro above -

 

 

 

Rockingham Stages:                £370 (1000cc ONLY) /   £395  /  £415  /  £475
Rockingham Sunday Stages:  £270 (1000cc ONLY) /   £295  /  £315  /  £375

£
Club Membership £
Charity Donation - suggested minimum £15.00£
Marshals Draw£
Total Money to be sent£
Payment Method - Indicate how you will be paying for your entry.
Entrant (if applicable and not driver)
Name
Address
Post Code
Telephone Number
Competition Licence Number
Comments
Anything else you'd like to tell us
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 events 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, Address, Post Code and email addresses to Mad Video and M and H Photography so that they can contact you with a view to offering you videos and 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  - even if your entry is subsequently cancelled. 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 pay the appropriate entry fee and to the following:

I declare that:

1) 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 competition and the potential risk inherent with motor sport and agree to accept that risk. I understand that motor sport can be dangerous and accidents causing death, injury, disability and property damage can and do happen. I understand that these risks may give rise to my suffering personal injury or other loss and I acknowledge and accept these risks.

2) To the best of my belief the driver(s) possess(es) the standard of competence necessary for an event of the type to which this entry relates and that the vehicle entered is suitable and roadworthy for the event having regard to the course and the speeds which will be reached. The use of the vehicle hereby entered will be covered by insurance as required by the law which is valid for such part of this event as shall take place on roads as defined by the law.

3) I understand that should I at the time of this event be suffering from any disability whether permanent or temporary which is likely to affect prejudicially my normal control of the vehicle, I may not take part unless I have declared such disability to the MSA which has, following such declaration, issued a licence which permits me to do so. I undertake that at the time of the event to which this entry relates I shall have passed or am exempt from an ASN specified medical examination within the specified period. (H10.1.6)

4) Any application form for a Licence which was signed by a person under the age of 18 years was countersigned by that person’s parent/legal guardian/guarantor, whose full names and addresses have been given.

5) If I am the Parent/Guardian/Guarantor of the driver I understand that I shall have the right to be present during any procedure being carried out under the Supplementary Regulations issued for this event and the General Regulations of the MSA. As the Parent/Guardian/Guarantor I confirm that I have acquainted myself and the minor with the MSA General Regulations, agree to pay any appropriate charges and fees pursuant to those Regulations (to include any appendices thereto) and hereby agree to be bound by those Regulations and submit myself without reserve to the consequences resulting from those Regulations (and any subsequent alteration thereof). Further, I agree to pay as liquidated damages any fines imposed upon me up to the maxima set out in Part 3, Appendix 1. Note: Where the Parent/Guardian/Guarantor is not present there must be a Guardian who must produce a written and signed authorisation to so act from the Parent/Guardian/Guarantor as appropriate.

6) I hereby agree to abide by the MSA Safeguarding Policy and Guidelines and the National Sporting Code of Conduct.

7) I have read and fully understood the Procedure for Control of Drugs and Alcohol as contained in the MSA Yearbook Regulations H39

8) I understand that my personal data is being processed solely for the purposes of running this event and will be handled by the organisers in accordance with the MSA data protection policy which can be found at www.msauk.org/dataprotection.

Indemnity: In consideration of the acceptance of this entry I agree that neither any one of or any combination of the MSA and its associated clubs, the organisers, the track owners or other occupiers, the promoters and their respective officers, servants, representatives and agents (the “Parties”) shall have any liability for loss or damage which may be sustained or incurred by me as a result of participation in the Event including but not limited to damage to property, economic loss, consequential loss or financial loss howsoever caused. Nothing in this clause is intended to or shall be deemed to exclude or limit liability for death or personal injury. To the fullest extent permitted by law I agree to indemnify and hold harmless each of the Parties in respect of any loss or damage whatsoever and howsoever arising from my participation in this event.

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