Knockhill Stages 2019 - Internet Entry Form

Document Addressing

E-Mail address for communication This must be filled in to continue

Real Name of this person This must be filled in to continue

Whom should we send final instructions and entry tickets to? This must be filled in to continue

Driver

Co-Driver

Driver

Full Name This must be filled in to continue

Address This must be filled in to continue

Post Code This must be filled in to continue

Home Town This must be filled in to continue

Telephone Number

Mobile Number

Competition Licence Number This must be filled in to continue

E-Mail Address This must be filled in to continue

Club (If no club is entered in here it is assumed you will require membership of DCC) You cannot sign on until this is filled in

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

Nationality

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 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

Competition Licence Number

Competition Licence Issuer

Co-Driver

Full Name This must be filled in to continue

Address This must be filled in to continue

Post Code This must be filled in to continue

Home Town This must be filled in to continue

Telephone Number

Mobile Number

Competition Licence Number This must be filled in to continue

E-Mail Address

Club (If no club is entered in here it is assumed you will require membership of DCC) You cannot sign on until this is filled in

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

Nationality

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 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

Competition Licence Issuer

Car

Make You cannot sign on until this is filled in

Model You cannot sign on until this is filled in

Colour

Registration Number

Engine Capacity

Year

Forced Induction / Rotary

No

Yes

Four Wheel Drive

No

Yes

Class You cannot sign on until this is filled in

A - Cars up to and including 1400cc

B - Cars between 1401cc and 1600cc

C - Cars between 1601cc and 2000cc

D1 - 2WD Cars of 2001cc and over

D2 - 4WD Cars of 2001cc and over

MX5 - Mazda MX5's Only between 1600 and 1800cc

MSUK GT - Production GT Cars *Subject to MSA Rule Publication

In Car Camera Request You cannot sign on until this is filled in

No in car camera

I will carry an in car camera

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

Service Vehicle

Make

Model

Colour

Registration Number

Sponsor

Sponsor Name (Note: this sponsor does not need an entrant's licence) You cannot sign on until this is filled in

Championships

Motorsport News Circuit Rally Championship

Crew Members Registered

None

Driver

Co-Driver

Both

Driver Championship Registration Number

Co-Driver Championship Registration Number

MSN Rally Champ Michelin Cup Competitor

Crew Members Registered

None

Driver

Co-Driver

Both

Driver Championship Registration Number

Co-Driver Championship Registration Number

MSN Rally Champ Protyre Challenge Competitor

Crew Members Registered

None

Driver

Co-Driver

Both

Driver Championship Registration Number

Co-Driver Championship Registration Number

MSN Rally Champ Hockly Swift Cup Competitor

Crew Members Registered

None

Driver

Co-Driver

Both

Driver Championship Registration Number

Co-Driver Championship Registration Number

Person to be contacted in case of serious accident to Driver

Name This must be filled in to continue

Address

Post Code

Telephone Number This must be filled in to continue

Relationship

Will this person be attending the event?

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

Name This must be filled in to continue

Address

Post Code

Telephone Number This must be filled in to continue

Relationship

Will this person be attending the event?

Seeding - Past Performance on Rallies

Event Name and Club

Year

Type

Surface

Overall Position

No of Starters

Seeding - Competitor Opinion

Out of 60 entries, where do you think you should be seeded? Please enter a exact number as entering a range or leaving blank makes seeding more difficult This must be filled in to continue

Scrutineering

When would you prefer to scrutineer? - Note The schedule on Sunday morning will be very tight. Please try to attend scrutineering on the saturday.

Saturday

Sunday (Strictly by appointment ONLY)

Fees - see above for how to pay

Entry Fee

£

Club Membership (Please Select)

£

Donation to the Marshals Fund (Please Select)

£

Total Money to be sent

£

Payment Method and Details

Bank Transfer (Ref Drivers Full Name)

Entrant (if applicable and not driver)

Name

Address

Post Code

Telephone Number

Nationality

Competition Licence Number

Competition Licence Issuer

Club Membership No

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.

Yes

No

We would also like to be allowed to pass on your Name, Address, Post Code and email addresses to TORQUE (Videographers) and SMJ Photography and any other signed on Media Photographers who are attending the event, 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.

Yes

No

The event is not currently open for entries

Bank	RBS
Sort Code	83-19-01
Account No.	00140673
Account Name	DCC
Reference	Driver's Inital and Surname

Knockhill Stages 2019 - Internet Entry Form

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

www.knockhill.com
www.dunfermlinecarclub.co.uk

Knockhill Stages 2019 - Internet Entry Form

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

www.knockhill.com www.dunfermlinecarclub.co.uk

www.knockhill.com
www.dunfermlinecarclub.co.uk