Phil Price Memorial Woodpecker Stages National Rally 2025

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

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

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

Competition Licence Issuer (if not Motorsport UK)

E-Mail Address

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 (if under 18)

Nationality

Driver's Parent or Guardian (under 18 only)

Name

Address (if different)

Post Code

Telephone Number

Relationship

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

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

Competition Licence Issuer (if not Motorsport UK)

E-Mail Address

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 (if under 18)

Nationality

Co-Driver's Parent or Guardian (under 18 only)

Name

Address (if different)

Post Code

Telephone Number

Relationship

Competing Car

Make You cannot sign on until this is filled in

Model You cannot sign on until this is filled in

Colour You cannot sign on until this is filled in

Registration Number You cannot sign on until this is filled in

Engine Capacity You cannot sign on until this is filled in

Year (particularly for Historic Competitors)

Forced Induction You cannot sign on until this is filled in

No

Yes

Four Wheel Drive You cannot sign on until this is filled in

No

Yes

In Car Camera Request You cannot sign on until this is filled in

Yes

No

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

If you are using your own insurance for the road sections of the rally please provide the name, policy number and address of the insurance company.

In doing so you are declaring that the cover provided complies with the requirements of the Road Traffic Act for the road sections of the rally.

Name

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 Make and Model

Make

Contact Name 1

Contact Number 1

Model

Colour

Registration 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.

Motorsport UK Fuchs Lubricants British Historic Rally Championship

British Historic Rally Championship

Crew Members Registered

None

Driver

Co-Driver

Both

Driver Championship Registration Number

Co-Driver Championship Registration Number

Motorsport UK Pirelli Welsh Rally Championship

Crew Members Registered

None

Driver

Co-Driver

Both

Driver Championship Registration Number

Co-Driver Championship Registration Number

ANWCC Stage Rally Championship

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

Person to be contacted in case of serious accident to Driver

Name You cannot sign on until this is filled in

Address You cannot sign on until this is filled in

Post Code You cannot sign on until this is filled in

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? You cannot sign on until this is filled in

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

Name You cannot sign on until this is filled in

Address You cannot sign on until this is filled in

Post Code You cannot sign on until this is filled in

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? You cannot sign on until this is filled in

Seeding - Past Performance on Rallies (not necessary for drivers who have competed on BTRDA or BHRC forest rallies in recent years)

Event Name and Club

Year

Surface

Overall Position

Class position

Fees - see above for how to pay

Entry Fee (see drop down options)

£

Sixty & Worcestershire MC Membership

£

REIS road section insurance or Own insurance- Please Select You cannot sign on until this is filled in

£

Total Money to be sent

£

Payment Method and Details You cannot sign on until this is filled in

Bank Transfer

Other

Entrant (if applicable and not driver)

Name

Address

Post Code

Telephone Number

Entrants MSA Licence Number

Club Membership No

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.

The event is not currently open for entries

Phil Price Memorial Woodpecker Stages National Rally 2025 - Internet Entry Form

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