DG Jones Agri Ltd. Powys Lanes Rally 2019 Internet Entry Form

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

Welcome to the online entry system for the D.G. Jones Agri Ltd Powys Lanes Rally 2019.

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

Please complete all the fields in the form below. The fields with red backgrounds are mandatory and 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.  

Once you have hit the 'Enter the Event' button at the end you will receive an automated email confirming we have received your entry form. This email will include a link which you can use to add any missing information or make any changes to your entry form. 

Entries close for seeding at 21.00hrs on Sunday 3rd November 2019. If vacancies are available in the relevant class then entries will be accepted up to 16.00hrs on Wednesday 6th November 2019.

 

Payment:

Direct payments by online or telephone banking are preferred and are the quickest way for us to process your entry. Please make payments to our HSBC account - Powys Lanes Rally, Sort Code 401514, Account Number 61408224, and give a Reference of Driver & Navigator Name.

Please make cheques payable to 'Powys Lanes Rally', write the name of Driver and Navigator on the back and post to the Entries Secretary at the address below. No Cheque entries will be accepted after Saturday 26th October 2019. Post dated cheques are not accepted.  

When we have received payment you should receive an e-mail confirming your entry. If you pay by cheque it might take up to 14 days for it to clear. If you don't receive a response within 3 days of the expected payment date, or if you have any other questions, please contact the Entries Secretary.

PLEASE NOTE - WITHOUT PAYMENT YOUR ENTRY WILL NOT BE ACCEPTED

 

Insurance:

If you wish to use JELF Insurance but are unable to comply with all points of Jelf Insurance Partnership's Declaration, you will be required to complete a Declaration Form (see Supplementary Regulations). A letter of acceptance will be issued and any loadings must be paid for at signing on with cash only.

If you intend to pay for JELF Insurance on the night please put 'ON THE NIGHT' in the Insurers 'Name and Policy No' box and select '0.00 - Own Insurance' in the Fees section.

 

Entries Secretary: 

Emma Lewis 

powysentrysec@epyntmc.co.uk

07939 226442 (No calls after 21:00hrs please)

5 Glandwr Park, Builth Wells, Powys, LD2 3DF

 

Document Addressing
E-Mail address for communication
Real Name of this person
Driver
Full Name
Address
Post Code
Telephone Number
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
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
Class
Insurers (If using own insurance)
Name
Address
Championships
WAMC Road Rally Championship
Crew Members Registered
Driver Championship Registration Number
Co-Driver Championship Registration Number
WAMC Junior Challenge
Crew Members Registered
Driver Championship Registration Number
Co-Driver Championship Registration Number
Association of North-Western Car Clubs Road and Navigation Rally Championship
Crew Members Registered
Driver Championship Registration Number
Co-Driver Championship Registration Number
Welsh Border Car Club Road Rally Championship
Crew Members Registered
Driver 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 (The best 4 results achieved in the last 5 years)
Event Name and ClubYearTypePlease list by Driver then NavigatorOverall PositionNo of Starters
Fees - see above for how to pay
Entry Fee £
Club Membership £
Insurance £
Total Money to be sent£
Payment Method and Details
Marshal Details
Name
Address
Post Code
Telephone Number
Mobile Number
Email Address
Experience
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 signed-on media representatives so that they can contact you with a view to offering you 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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