Kingdom Stages Rally 2022 - 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 Finals and Results to?

Driver

Co-Driver

Driver

Full Name This must be filled in to continue

Address You cannot sign on until this is filled in

Post Code You cannot sign on until this is filled in

Home Town You cannot sign on until this is filled in

Telephone Number

Mobile Number You cannot sign on until this is filled in

Competition Licence Issuer

Motorsport UK

Motorsport Ireland

Other ASN

Competition Licence Number You cannot sign on until this is filled in

Email Address You cannot sign on until this is filled in

Club You cannot sign on until this is filled in

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

Date of Birth

Medical condition or disability or on anti-coagulant therapy (solely for use of Chief Medical Officer in the event of an accident - please provide details in "Comments") This must be filled in to continue

Yes

No

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 (per K10.3.1) 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 (per K10.3.1) 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

Co-Driver

Full Name This must be filled in to continue

Address You cannot sign on until this is filled in

Post Code You cannot sign on until this is filled in

Home Town You cannot sign on until this is filled in

Telephone Number

Mobile Number You cannot sign on until this is filled in

Competition Licence Issuer

Motorsport UK

Motorsport Ireland

Other ASN

Competition Licence Number You cannot sign on until this is filled in

Email Address You cannot sign on until this is filled in

Club You cannot sign on until this is filled in

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

Date of Birth

Medical condition or disability or on anti-coagulant therapy (solely for use of Chief Medical Officer in the event of an accident - please provide details in "Comments") This must be filled in to continue

Yes

No

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 (per K10.3.1) 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 (per K10.3.1) 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

Make This must be filled in to continue

Model This must be filled in to continue

Colour You cannot sign on until this is filled in

Registration Number You cannot sign on until this is filled in

Engine Capacity (cc) You cannot sign on until this is filled in

Forced Induction

No

Yes (Motorsport UK 1.7x equivalence applies)

Four Wheel Drive

No

Yes

Class This must be filled in to continue

1 - Class 1 - Up to 1400cc

2 - Class 2 - 1401cc to 1600cc

3 - Class 3 - 1601cc to 2000cc

4 - Class 4 - 2001cc and above 2WD

5 - Class 5 - 2001cc and above 4WD

In Car Camera Request

No

Yes I have 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

Championships

Scottish Single Venue Rally Championship

Crew Members Registered

None

Driver

Co-Driver

Both

Scottish Tarmack Rally Championship

Crew Members Registered

None

Driver

Co-Driver

Both

Person to be contacted in case of serious accident to Driver

Name You cannot sign on until this is filled in

Address

Post Code

Telephone Number You cannot sign on until this is filled in

Relationship You cannot sign on until this is filled in

Will this person be attending the event?

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

Name You cannot sign on until this is filled in

Address

Post Code

Telephone Number You cannot sign on until this is filled in

Relationship You cannot sign on until this is filled in

Will this person be attending the event?

Seeding - Past Performance on Rallies since 1 Jan 2017

Event Name and Club

Year

Surface

Overall Finishing Position

No of Starters

Seeding - Competitor Opinion

Out of 65 entries, where do you think you should be seeded? This must be filled in to continue

Fees - see above for how to pay

Entry Fee

£

Total Money to be sent

£

Payment Method and Details

Bank Transfer

Pay at any branch of Bank of Scotland

Other method already agreed with the organisers

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.

No

Yes

We would also like to be allowed to pass on your Name, Address, Post Code and email addresses to our chosen Media entity/ies so that they can contact you with a view to offering you videos and photos of you "on event". If you are happy to allow us to do this, please say so here.

No

Yes

The event is not currently open for entries

Bank	Bank of Scotland
Sort Code	80-16-84
Account No.	00602954
Account Name	Glenrothes Motor Sport Club
Reference	Driver's First Name and Surname

Kingdom Stages Rally 2022 - Internet Entry Form

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