Cefni Garage Targa Rally 2019 - Internet Entry Form

Entries Close at 18:00 hours on Monday,14h October, 2019.

C&A Motor Club
31 Brig y Nant
Llangefni
LL77 7QD

Held under the General Regulations of Motorsport UK(incorporating the International Sporting Code of the FIA) and the Supplementary Regulations.

Welcome to the Caernarvonshire & Anglesey Motor Club's Cefni Garage Targa Rally online entry system. Please follow the steps below to enter the rally.

YOU HAVE A CHOICE OF THREE WAYS TO PAY:
A) If you would like to pay via credit card, debit card or PayPal, you will get a link after you fill in the entry form to take you to PayPal's website where you can pay for your entry by card or PayPal (use the reference: TR + driver's name). Note that we do not see your card details at all as this is all handled for us by PayPal and there is no additional fee for using this facility.
B) If you have internet or telephone banking, you can arrange for the fees to be paid directly into our account. The details are:-

C) You can send a cheque, made payable to 'Caernarvonshire & Anglesey Motor Club Ltd' to the Entries Secretary at the address above (your entry will not be confirmed until the cheque is cashed).

C&A Motor Club club membership fees, if necessary, will be collected at signing-on.

All the fields with a red background must be completed, otherwise you will not be able to continue.

Document Addressing

E-Mail address for communication - please enter carefully! This must be filled in to continue

Actual name of this person This must be filled in to continue

Driver

Driver This must be filled in to continue

Address

Post Code

Telephone Number

Mobile Number

E-Mail Address

Club Membership No You cannot sign on until this is filled in

Date of Birth if under 21 years old

Helmet Make You cannot sign on until this is filled in

Helmet Model You cannot sign on until this is filled in

Helmet Approval Standard You cannot sign on until this is filled in

FHR Make You cannot sign on until this is filled in

FHR Model You cannot sign on until this is filled in

FHR Approval Standard You cannot sign on until this is filled in

Driver's Parent or Guardian (under 18 only)

Name

Address (if different)

Post Code

Telephone Number

Relationship

Competition Licence Number

Competition Licence Issuer

Navigator

Navigator This must be filled in to continue

Address

Post Code

Telephone Number

Mobile Number

E-Mail Address

Club Membership No You cannot sign on until this is filled in

Helmet Make You cannot sign on until this is filled in

Helmet Model You cannot sign on until this is filled in

Helmet Approval Standard You cannot sign on until this is filled in

FHR Make You cannot sign on until this is filled in

FHR Model You cannot sign on until this is filled in

FHR Approval Standard You cannot sign on until this is filled in

Co-Driver's Parent or Guardian (under 18 only)

Name

Address (if different)

Post Code

Telephone Number

Relationship

Competition Licence Issuer

Car & Class

Make You cannot sign on until this is filled in

Model You cannot sign on until this is filled in

Colour

Registration Number

Cubic capacity

Class entered as a crew (see SR 7) This must be filled in to continue

1 - Expert

2 - Semi Expert

3 - Novice

Competition Car Logbook Number You cannot sign on until this is filled in

Car Seats and Harnesses

Left Harness FIA Homologation Expiry Date You cannot sign on until this is filled in

Right Harness FIA Homologation Expiry Date You cannot sign on until this is filled in

Left Seat FIA Homologation Expiry Date You cannot sign on until this is filled in

Right Seat FIA Homologation Expiry Date You cannot sign on until this is filled in

Car Fire Extinguishers

Hand-held fire extinguisher make You cannot sign on until this is filled in

Hand-held fire extinguisher capacity You cannot sign on until this is filled in

Hand-held fire extinguisher last service date You cannot sign on until this is filled in

Plumbed-in fire extinguisher make You cannot sign on until this is filled in

Plumbed-in fire extinguisher capacity You cannot sign on until this is filled in

Plumbed-in fire extinguisher last service date You cannot sign on until this is filled in

Person to be contacted in case of serious accident to Driver

Name and relationship

Address

Post Code

Telephone Number

Relationship

Person to be contacted in case of serious accident to Co-Driver

Name and relationship

Address

Post Code

Telephone Number

Relationship

Seeding - Past Performance on Rallies

Event Name

Year

Status

Class Entered

Class Position

Overall Position

Fees - see above for how to pay

Entry Fee

Total Money to be sent

Payment Method This must be filled in to continue

Cheque sent to Entries Secretary.

Bank Transfer - details at top of page. Reference = TR and driver's name.

PayPal - option offered on completion of form. Reference = TR + driver's name

Marshal Details

Name

Mobile Number

Email Address

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 may 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.

Yes

We would also like to be allowed to pass on your email addresses to an official photographer who may offer you photos of you on the event. If you are happy to allow us to do this, please say so here.

Yes

The event is not currently open for entries

Bank	HSBC
Sort Code	40-16-02
Account No.	01166034
Account Name	C&A Motor Club
Use the reference:	TR + Driver's name.

Cefni Garage Targa Rally 2019 - Internet Entry Form

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