Plains Rally 2024 - 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

How would you like to receive Finals and Results?

E-mail/Website

Posted Paper

Driver

Full Name This must be filled in to continue

Address

Post Code

Home Town

Telephone Number

Mobile Number

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

E-Mail Address

Club You cannot sign on until this is filled in

Date of Birth

Nationality

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

Post Code

Home Town

Telephone Number

Mobile Number

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

E-Mail Address

Club You cannot sign on until this is filled in

Date of Birth

Nationality

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

Engine Capacity

Year

Forced Induction

No

Yes

Four Wheel Drive

No

Yes

Competition Car Logbook Number You cannot sign on until this is filled in

If using your own insurance

Insurer's Name

Broker or Insurer's Address

If you wish to use the road section insurance, can you comply with the Insurance Declaration quoted in the regulations? You cannot sign on until this is filled in

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

Service vehicle details

Make

Model

Colour

Registration Number

Contact Name

Contact Number

service crew member

Contact Name

Contact Number

Contact Name

Contact Number

Contact Name

Contact 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

Motorsport Uk Pirelli Welsh Rally Champioship

Crew Members Registered

None

Driver

Co-Driver

Both

Driver Championship Registration Number

Co-Driver Championship Registration Number

The West Wales Rally Spares HRCR Stage Masters Challenge

Crew Members Registered

None

Driver

Co-Driver

Both

Driver Championship Registration Number

Co-Driver Championship Registration Number

ANWCC Forest Rally Championsip

Crew Members Registered

None

Driver

Co-Driver

Both

Driver Championship Registration Number

Co-Driver Championship Registration Number

SD34 Stage Rally Championshipo

Crew Members Registered

None

Driver

Co-Driver

Both

Driver Championship Registration Number

Co-Driver Championship Registration Number

TCS Plant Rally Championship

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

Surface

Overall Position

Class Position

Seeding - Competitor Opinion

Out of 120 entries, where do you think you should be seeded?

Scrutineering

Would you like your Road Book emailing? You cannot sign on until this is filled in

No

Yes

Fees - see above for how to pay

Entry Fee

£

Club Membership

£

Insurance

£

Support the Marshals Donation

£

Total Money to be sent

£

Payment Method and Details
BACS / Bank transfer This must be filled in to continue

Entrant (if applicable and not driver)

Name

Address

Post Code

Telephone Number

Nationality

Competition Licence Number

Competition Licence Issuer

Club Membership No

Comments

Extra comments you feel might be relevant for seeding or about your entry

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

No