Rallynuts Stages Rally 2019 Internet Entry Form

organised by Midland Manor Motor Club

Saturday 13th April 2019. Builth Wells

Entries Close for seeding on Thursday 4th April 2019

Entries Secretary: Dave Lancaster
Telephone 01584 881549 or 07976 620288 (No calls after 9PM please)
E-mail: entries@rallynutsrally.co.uk

 

 

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

Welcome to the Rallynuts Stages Rally 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. You will not be able to submit your entry until these mandatory fields are completed. Put TBA in any red field which you do not know the details for and please email this information to us when you have it.
  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.
  3. Entries will only be acknowledged on receipt of full payment. We are offering various payment methods including Stripe (and Credit Card), Direct BACS transfer or payment by cheque including post-dated payments using two differently dated cheques. Please refer to event Regulations articles 8.7 thru 8.12 for more details.
  4. Cheques must be made payable to 'Midland Manor Motor Club' and sent to the entries secretary: Dave Lancaster, Linkhill View, Frith Common, Tenbury Wells, Worcestershire, WR15 8JX. - PLEASE write Drivers full name as reference on back of cheque(s) if not the same as on the front.
  5. Alternatively payment may be made electronically to - Midland Manor Motor Club Ltd. -  Sort Code 30 00 03 - Account Number 00501253
  6. Within 48 hours of us receiving the payment for your entry you should receive an e-mail confirming your entry from the Entries Secretary. NOTE: WITHOUT PAYMENT YOUR ENTRY WILL NOT BE VALID.
  7. If you don't receive a response within 4 days of the expected payment date, or if you have any other questions, please e-mail entries@rallynutsrally.co.uk
  8. All competitors will be expected to sign the Indemnity document at signing on. Your entry here is accepted on this understanding. All competitors under the age of 18 will require the signature of their parent or guardian as Guarantor. A Guarantor is expected to attend the event and sign-on as an entrant. If they are unable to be present, a representative can attend, but must produce the Guarantor's written and signed authorisation to act on their behalf. Full text of the Indemnity document is included at the end of the on-line entry form.

Camping at the Show Ground in Builth Wells costs £12 per pitch / per night  (tent, caravan or motorhome) or £14 with electricity. Toilet and shower facilities are available. Tickets are purchasable with your entry and will also be available at signing-on. There are limited number of pitches with electricity and therefore we recommend booking as part of your entry.

The Print'n'Post version of the entry form can be found HERE


All the data entered on this page or provided on Print'n'Post entry forms will be stored on a computer for the purposes of administering the event and to promote future Rallynuts Stages Rally, and will not be passed to any third parties.

PLEASE ensure that you click the 'Enter the event' button at the end of the Entry Form.

 

Document Addressing
E-Mail address for ALL pre-event communications including Entry Acknowlegements
Full Name of this person
Driver
Full Name
Address
Post Code
Home Town
Telephone Number
On-event Mobile Number
Competition Licence Number
E-Mail Address
Club
Nationality
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
On-event Mobile Number
Competition Licence Number
E-Mail Address
Club
Nationality
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
Will you be using an In Car Camera? (See Articles SR 12.9 and 21.4)
If using your own RTA insurance .. (See Article SR 20)
Name and Address of Vehicle Insurer and Insurance Agent (D.12.3.6)
Policy Number and Expiry Date
On-event Contact Numbers
Contact number for Service Crew
Contact number for Management Vehicle
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 in the Comments section below).
Championships
Jordan Road Surfacing BTRDA Rally Series 2019
Crew Members Registered
Driver Championship Registration Number
Co-Driver Championship Registration Number
Pirelli Motorsport UK Welsh Rally championship 2019
Crew Members Registered
Driver Championship Registration Number
Co-Driver Championship Registration Number
Brian Dennis Motorsport/www.jelfmotorsport.com Welsh Historic Rally championship 2019
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
West Wales Rally Spares HRCR Stage Masters challenge 2019
Crew Members Registered
Driver Championship Registration Number
Co-Driver Championship Registration Number
FMP Rally Challenge 2019
Crew Members Registered
Driver Championship Registration Number
Co-Driver Championship Registration Number
Person to be contacted in case of emergency involving the Driver
Name
Address
Post Code
Telephone Number
Will this person be attending the event?
Person to be contacted in case of emergency involving the Co-Driver
Name
Address
Post Code
Telephone Number
Will this person be attending the event?
Seeding Information - Previous results for Forest Stage Rallies contested as Driver
Event NameDateEvent StatusOverall PositionClass Position
Seeding - Competitor Opinion
Out of 50 entries, where do you think you should be seeded?
Scrutineering
When would you prefer to scrutineer? (Please select no more than 2 slots) 13:00
13:30
14:00
14:30
15:00
15:30
16:00
16:30
17:00
17:30
18:00
18:30
Saturday 07:30 (Prior Appointment Only)
Saturday 08:00 (Prior Appointment Only)
Fees and Preferred Method of Payment
Entry Fee £
Insurance £
Midland Manor Motor Club Memberships£
Management Packs£
Support the marshals stickers£
Camping£
Total Money to be sent£
Payment Method and Details
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 [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.

Remember your entry is subject to receipt of the correct entry fee. An automated acknowledgement is NOT confirmation of entry. Rejected entries and entries held in abeyance will be notified by e-mail to the address given above.

By clicking on the "Enter the Event" button below you agree to the following:

I consent to the organising committee using the information I have given for the purpose of displaying relevant details on an entry list to be made available to the public via written and electronic means, and for mailings to administer and promote future Rallynuts Stages Rallies.  The information provided will be treated in confidence and will be held in compliance with the Data Protection Act 1998.  Crews personal details will be shared with members of the Rally and MMMC Committees and address labels/e-mail addresses provided to the Media Officer and Official Photographers/Media of the event for the purposes of distributing Press Releases and advertising their services.  I understand you cannot verify that the Official Photographers/Media will not share such information with other organisations or individuals.
 
MOTORSPORT UK INDEMNITY DECLARATION

Held under the General Regulations of the Royal Automobile Club Motorsport UK (incorporating the provisions of the International Sporting Code of the FIA) these Supplementary Regulations and any written instructions the Club may issue for the Event.

I declare that I have been given the opportunity to read the General Regulations of the Motorsport UK 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 the competition and the potential risk inherent with motor sport and agree to accept that risk

I understand that motorsport 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. In consideration of the acceptance of this entry I agree that neither any one of or any combination of Motorsport UK 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.

I declare that 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.

If I am the Parent or Guardian 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 Motorsport UK.’ As the Parent/Guardian ‘I confirm that I have acquainted myself and the minor with Motorsport UK 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.

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 my vehicle, I may not take part unless I have declared such disability to the ASN which has,following such declaration, issued a licence which permits me to do so.

I have read and fully understood the regulations for Control of Drugs and Alcohol as contained in the Competitors’ and Officials’ Yearbook Regulations H39, D35.1, G15.1.4 and have also fully familiarised myself with the information on the web sites referred to (www.motorsportuk.org, www.ukad.org.uk and www.wada-ama.org) in particular the UK Anti Doping Rules which have been adopted by Motorsport UK. Further, if I am counter-signing as the Parent or Guardian of a minor then in addition to the deemed consent to the testing of that minor UK Anti-Doping Rule 5.7.2) I hereby confirm that I give such consent for the minor concerned to be so tested.

I hereby agree to abide by the Motorsport UK Safeguarding Policy and Guidelines and the National Sporting Code of Conduct.

 

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