Document Addressing E-Mail address for communication Real Name of this person Whom should we send Finals and Results to? Driver Co-DriverDriver Full Name Address Post Code Home Town Telephone Number Mobile Number Competition Licence Number Competition Licence Issuer E-Mail Address Club Date of Birth Nationality Driver Publicity Hobbies Married? No of Children How Long Rallying? Notable Results Any other information Driver's Parent or Guardian (under 18 only) Name Address (if different) Post Code Telephone Number Relationship Co-Driver Full Name Address Post Code Home Town Telephone Number Mobile Number Competition Licence Number Competition Licence Issuer E-Mail Address Club Date of Birth Nationality Co-Driver Publicity Hobbies Married? No of Children How Long Rallying? Notable Results Any other information Co-Driver's Parent or Guardian (under 18 only) Name Address (if different) Post Code Telephone Number Relationship Car Make Model Colour Registration Number Engine Capacity Year Forced Induction No YesFour Wheel Drive No YesClass - Catergory 1 registered before 31.12.67 B2 - Cars upto 1300cc B3 - Over 1301cc to 1600cc including excluding Twin Cam engined cars B4 - Over 1601cc including Twin Cam engined cars B5 - Cars Over 2000cc including Porsche 911's - Catergory 2 registered between 01.01.68 and 31.12.74 C2 - Cars upto 1600cc including 2 vavle twin cam engines C3 - Over 1601cc upto 2000cc C5 - Cars over 2000cc including ALL multi valve Twin Cam engines - Category 3 registered between 01.01.75 and 31.12.81 D2 - Cars upto 1600cc including 2 valve Twin Cam engines D3 - Over 1601cc to 2000cc D5 - All other Mutli valve Twin Cam engined cars - Category 4a registered between 01.01.82 and 31.12.85 E1 - Cars upto 1600cc E2 - Cars Over 1601cc - Category 4b Registered between 01.01.86 and 31.12.90 F1 - Cars upto 1600cc F2 - Cars over 1601cc - Category K FIA appendix K cars registered before 31.12.85 G1 - Cars upto 1600cc G2 - Cars over 1601cc - 2WD None Historic Cars M1 - 2WD Cars upto 1400cc M2 - 2WD Cars 1401cc to 1600cc M3 - 2WD Cars 1601cc to 2000cc M4 - 2WD Cars Over 2001cc RF1.4 - BTRDA Rally First over 1000cc upto and including 1400cc RF1.6 - BTRDA Rally First cars over 1400cc upto and including 1600cc RF2.0 - BTRDA Rally First over 1600cc up to and including 2000cc 1400C - Car up to 1400cc complying with A-D 1400S - All other cars up to and including 1400cc N3 - Current and former FIA Group N cars over 1400cc up to and including 2000cc NR4 - Current and former FIA Group N cars over 2000cc B10/R2 - Over 1400cc up to and including 1600cc including all FIA R2B Cars B11 - Over 1600cc up to and including 2000cc B12 - Over 2000cc two wheel drive, including all FIA R3T cars B13 - Over 2000cc four wheel drive cars that do not qualify for classes NR4 & B14 & FIA R4 cars B14 - Current and Former WRC, S2000 & R5 cars H1/2 - All Historic Category 1, 2 & 3 with single cam engines H3 - Historic Category 3 with multi cam engines over 1600cc, plus Category 4a and 4B cars upto 1600cc H4 - Historic Category 4b cars over 1600cc which comply with R49.1.5In Car Camera Request FIA Homologation Number Insurers Name Address 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 FUCHS Lubricants MSA British Historic Rally Championship Crew Members Registered None Driver Co-Driver BothDriver Championship Registration Number Co-Driver Championship Registration Number Motorscope Northern Historic Rally Championship Crew Members Registered None Driver Co-Driver BothDriver Championship Registration Number Co-Driver Championship Registration Number Rally 2WD Challenge Crew Members Registered None Driver Co-Driver BothDriver Championship Registration Number Co-Driver Championship Registration Number JORDAN ROAD SURFACING Gold Star Championship Crew Members Registered None Driver Co-Driver BothDriver Championship Registration Number Co-Driver Championship Registration Number JORDAN ROAD SURFACING Silver Star Championship Crew Members Registered None Driver Co-Driver BothDriver Championship Registration Number Co-Driver Championship Registration Number BTRDA 1400 Rally Championship Crew Members Registered None Driver Co-Driver BothDriver Championship Registration Number Co-Driver Championship Registration Number BTRDA Rally First Championship Crew Members Registered None Driver Co-Driver BothDriver Championship Registration Number Co-Driver Championship Registration Number ST Trophy Crew Members Registered None Driver Co-Driver BothDriver Championship Registration Number Co-Driver Championship Registration Number BTRDA Rallye R2 Cup Crew Members Registered None Driver Co-Driver BothDriver Championship Registration Number Co-Driver Championship Registration Number BTRDA Historic Cup Crew Members Registered None Driver Co-Driver BothDriver Championship Registration Number Co-Driver Championship Registration Number BTRDA Production Cup Crew Members Registered None Driver Co-Driver BothDriver Championship Registration Number Co-Driver Championship Registration Number Maxxis Tyres MSA English Rally Championship Crew Members Registered None Driver Co-Driver BothDriver Championship Registration Number Co-Driver Championship Registration Number Border Challenge Crew Members Registered None Driver Co-Driver BothDriver 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 Scrutineering Fees - see above for how to pay Entry Fee £ Club Membership £0.00 - None 15.00 - Driver 15.00 - Co-Driver 30.00 - Both Insurance £0.00 - Own Insurance 20.00 - REIS Insurance Donation to Marshals £? up to you. £ Management pack £0.00 - None 20.00 - Managegment Pack Total Money to be sent £ Payment Method and Details Cheque made Payable to 'Roger Albert Clark Rally Motor Club' Please write drivers full name on the back. Bank transfer to, Sort Code 80 - 12 - 08 Account Number 06002797, Reference should contain the drivers full nameEntrant (if applicable and not driver) Name Address Post Code Telephone Number Nationality Competition Licence Number Competition Licence Issuer 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
Remember your entry is subject to receipt of the correct entry fee. An automated acknowledgement is NOT confirmation of entry. Rejected entries and entries held in abeyance will be informed by e-mail to the address(es) given above.
By clicking on the "Enter the Rally" button below you agree to the following: "I declare that I have been given the opportunity to read the General Regulations of the Motor Sports Association and, if any, the Supplementary Regulations for this event and agree to be bound by them. I declare that I am physically and mentally fit to take part in the event and I am competent to do so. I acknowledge that I understand the nature and type of the competition and the potential risk inherent with motor sport and agree to accept that risk. Further, I understand that all persons having any connection with the promotion and/or organisation and/or conduct of the event are insured against loss or injury caused through their negligence."