Harold Palin Memorial Stages October 6th 2019 Internet Entry Form

THIS EVENT IS IN TEST MODE

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

Welcome to the Harold Palin Memorial on line Entries

Entries Close for seeding on Saturday 27th September 2019

If places remain entries will be accepted up to Thursday 3rd October 2019 but will not be included in the seeding.

 

Secretary: Sandra Hickling

18 Philip Ave,Nuthall,Nottinghamshire, NG16 1EA

Telephone 0115 9384601 (Evenings before 9.30pm Only)

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

 

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 and must be filled in.
  2. We reserve the right to reject entries submitted with insufficient information, Please complete as much as possible prior to submitting as this will aid your entry status.
  3. 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 on the entries system.
  4. When your entry has been checked you will receve a further email with a receipt number. this is an aknowledement we have checked it, but is NOT an acceptance of your entry.
  5. Your entry will only be classed as an accepted entry upon receipt of the FULL entry fee .
  6. We will not enter in to any discussions regarding when funds were submitted it is when your entry fee arrives in our accout that matters.
  7. There are two ways to pay
  8. Please send a cheque  made payable to  Eastwood & District Motor Club  Stages Account to the  Secretary at the address above. If paying by Cheque, please ensure you put the drivers name and recept number on the reverse.
  9. If you have internet or telephone banking, you can arrange for the fees to be paid directly into our account.
  10. The entry fee is £260

The Bank account

Bank

details are:

 Yorkshire Bank
Sort Code  05.0642
Account No.  48969415
Account Name Eastwood & District Motor Club ltd Stages account
Reference Driver's First name and Surname

 

  1. Within 24 hours of us receiving the payment for your entry you should receive an e-mail confirming your entry from the entries Secretary.
  2.  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:.hpmemorialstages@btinternet.com 
  3. Entries  are only secured by receipt of a FULLY PAID enty fee untill the enty fee is receved your status is Acknowledged and a run is not garenteed
  4.  

All the fields with a red background must be filled in, or you will not be able to continueyou can put TBA in any red field which you do not know the details for but remember to many may course a delay in processing you entry.

Document Addressing
E-Mail address for communication
Real Name of this person
Whom should we send Finals and Results to?
How would you like to receive Finals and Results?
Driver
Full Name
Address
Post Code
Home Town
Mobile Number
Competition Licence Number
E-Mail Address
Club
Date of Birth
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
E-Mail Address
Club
Date of Birth
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
Forced Induction
Four Wheel Drive
Class
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
Roadrunner Phoenix awards ANEMMC Stage Rally Championship
Crew Members Registered
Wemix Concrete LTD EMAMC Stage Rally Championship
Crew Members Registered
ANCC Stage Rally Championship
Crew Members Registered
Bimma Cup
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 with out this information YOU WILL NOT BE SEEDED
Event Name and ClubYearpermit typeSurfaceOverall PositionClass position
Seeding - Competitor Opinion
Out of 60 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
£260 		£
For Club Membership See the Club Website for membership forms

 

 

 

 

£
The Alzheimer's Society£
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 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 [INSERT VIDEO COMPANY HERE] and [INSERT PHOTO COMPANY HERE] 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.

The event is not currently open for entries

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