The Buildbase Questmead Stages 2022

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

Driver

Full Name This must be filled in to continue

Address This must be filled in to continue

Post Code You cannot sign on until this is filled in

Town You cannot sign on until this is filled in

Telephone Number This must be filled in to continue

Mobile Number This must be filled in to continue

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

E-Mail Address This must be filled in to continue

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 This must be filled in to continue

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 publicity information for Special Stage live event commentary.

How long have you been 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 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 Number You cannot sign on until this is filled in

E-Mail 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

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 publicity information for Special Stage live event commentary.

How long have you been 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 You cannot sign on until this is filled in

Engine Capacity You cannot sign on until this is filled in

Forced Induction

No

Yes

Class You cannot sign on until this is filled in

A - up to 1000cc

B - 1001cc - 1400cc

C - 1401cc - 1600cc

D - 1601cc - 2000cc

E - 2001cc and over

H - Historic Vehicles (must comply with R 49.1)

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

First Service Crew

Contact Name

Contact Number

Second Service Crew

Contact Name

Contact Number

Third Service Crew

Contact Name

Contact Number

Service Vehicle

Make

Model

Colour

Registration Number

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

Association of North Western Car Clubs Championship 2022

Crew Members Registered

None

Driver

Co-Driver

Both

6R4.com Three Sisters Rally Challenge 2022

Crew Members Registered

None

Driver

Co-Driver

Both

Mini Challenge 2022

Crew Members Registered

None

Driver

Co-Driver

Both

SD34 Motorsport Group Stage Rally Championship 2022

Crew Members Registered

None

Driver

Co-Driver

Both

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 You cannot sign on until this is filled in

Address

Post Code

Telephone Number You cannot sign on until this is filled in

Relationship

Will this person be attending the event?

Seeding - Past Performance on Stage Rallies by Driver Only
We can only seed you on the information you supply - please give as much detail as possible.

Event Name and Club

Year

Type

Surface

Overall Position

Class Position

Fees - see above for how to pay

Entry Fee

£

Club Membership

£

Insurance

£

Marshal Fund

£

SD34 2022 Championship Registration

£

Total Money to be sent

£

Payment Method and Details This must be filled in to continue

Entrant (if applicable and not driver)

Name

Address

Post Code

Telephone Number

Competition Licence Number

Competition Licence Issuer

Club Membership No

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, video and the official photographer for the event.

We would like 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 for us to do this, please indicate here.

No

Yes

If you consent to us sharing your Name, Address, Post Code and email addresses to the official photographer and Special Stage team, please say so here.

No

Yes

The event is not currently open for entries

The Buildbase Questmead Stages 2022 - Internet Entry Form

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

Seeding - Past Performance on Stage Rallies by Driver Only
We can only seed you on the information you supply - please give as much detail as possible.

The Buildbase Questmead Stages 2022 - Internet Entry Form

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

Seeding - Past Performance on Stage Rallies by Driver Only We can only seed you on the information you supply - please give as much detail as possible.

Seeding - Past Performance on Stage Rallies by Driver Only
We can only seed you on the information you supply - please give as much detail as possible.