Eagle Road Rally 2023 - Internet Entry Form

Entries Secretary: Amy Horn

e-mail: eagleentries@gmail.com

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

All the fields with a Red background must be filled in, or you will not be able to continue.

TBA/C is not an accepted term, you entry will not be classed as accepted until details are completed in full.

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 This must be filled in to continue

Post Code This must be filled in to continue

Mobile Number This must be filled in to continue

Competition Licence Number This must be filled in to continue

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

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

Mobile Number This must be filled in to continue

Competition Licence Number This must be filled in to continue

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

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 This must be filled in to continue

Registration Number This must be filled in to continue

Engine Capacity This must be filled in to continue

Year You cannot sign on until this is filled in

Class This must be filled in to continue

A - Masters

B - Expert

C - Semi Expert

D - Novice

Insurers

Name & policy No

Address

If you wish to use the road section insurance, can you comply with the Insurance Declaration quoted in the regulations? This must be filled in to continue

Yes - I wish to use the insurance and I comply with all points

No - I wish to use the insurance but do not comply (please contact me)

N/A - I have my own insurance

Championships

WBCC RRC

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

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

Event Name and Club

Year

Type

Overall Position

No of Starters

Fees - see above for how to pay

Entry Fee £130.00

Club Membership

Insurance

Total Money to be sent

Payment Method and Details This must be filled in to continue

Marshal Details

Name

Mobile Number

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.

Yes

The event is not currently open for entries

Eagle Road Rally 2023 - Internet Entry Form

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