The Pentraeth Automotive Group Glyn Memorial Trophy Stages 2018 Internet Entry Form

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

Entries Close on 19/11/2018

Entries Secretary:

Rhian Jones

31 Brig y Nant

Llangefni

Anglesey

LL77 7QD

Tel: 07780 933531

E-Mail: rhianowenjones@outlook.com

Held under the General Regulations of the Motor Sports Association (incorporating the International Sporting Code of the FIA) and the Supplementary Regulations.

Welcome to the Caernarvonshire & Anglesey Motor Club Ltd, Pentraeth Automotive Group Glyn Memorial Trophy Stages 2018 online entry system. Please follow the steps below to enter the rally.

  1. Complete all the fields in the form below. The fields with red backgrounds are mandatory.
  2. Once you have hit the "Enter the Rally" button at the end you will receive an automated response confirming we have received your entry form.
  3. There are three ways to pay
    1. If you would like to pay via credit, debit card or Paypal, you will get a link after you fill in the entry form to take you to Paypal's website, where you can pay for your entry by card or paypal. Note that we do not see your card details at all, this is all handled for us by Paypal.
    2. If you have internet or telephone banking, you can arrange for the fees to be paid directly into our account. The details are:-
      Bank HSBC
      Sort Code  40-16-02
      Account No.  01166034
      Account Name C&A Motor Club
      Reference Driver's full name.
    3. You can send a cheque, made payable to 'Caernarvonshire & Anglesey Motor Club Ltd' to the Entries Secretary at the address above (your entry will not be confirmed until cheque is cashed)
  4. Within 3 days of us receiving the payment for your entry you should receive an e-mail confirming your entry from the Entries Secretary. NOTE: WITHOUT PAYMENT YOUR ENTRY WILL NOT BE VALID.
  5. If you don't receive a response within 7 days of the expected payment date, please e-mail rhianowenjones@outlook.com.

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

Document Addressing
E-Mail address for communication
Real Name of this person
Whom should we send Finals and Results to?
Driver
Full Name
Address
Post Code
Telephone Number
Mobile Number
Competition Licence Number
E-Mail Address
Club
Date of Birth if under 18 years old
Driver's Parent or Guardian (under 18 only)
Name
Address (if different)
Post Code
Telephone Number
Relationship
Co-Driver
Full Name
Address
Post Code
Telephone Number
Mobile Number
Competition Licence Number
E-Mail Address
Club
Date of Birth if under 18 years old
Co-Driver's Parent or Guardian (under 18 only)
Name
Address (if different)
Post Code
Telephone Number
Relationship
Car
Make
Model
Colour
Registration Number

CC

4WD
Class
Event - YOU MUST SELECT AN OPTION
Which event do you want to enter?
Championships
ANWCC Stage Rally Championship
Crew Members Registered
Driver Championship Registration Number
Co-Driver Championship Registration Number
ANWCC North Wales Rally Challenge
Crew Members Registered
Driver Championship Registration Number
Co-Driver Championship Registration Number
ANWCC Ladies Rally Championship
Crew Members Registered
Driver Championship Registration Number
Co-Driver Championship Registration Number
ANWCC Allrounders Championship
Crew Members Registered
Driver Championship Registration Number
Co-Driver Championship Registration Number
The Yokohama Tyres Senior Formula 1000 Championship
Crew Members Registered
Driver Championship Registration Number
Co-Driver Championship Registration Number
Junior 1000 Rally Championship
Crew Members Registered
Driver Championship Registration Number
Co-Driver Championship Registration Number
The Glynne Edwards Memorial Championship
Crew Members Registered
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

Year

Status

O/A PositionClass Position
Fees - see top of page for details of how you can pay
Entry Fee £
Club Membership £
Total Money to be sent£
Payment Method
Entrant (if applicable)
Name
Address
Post Code
Telephone Number
Competition Licence Number
Garage
Would you like to be entered into the raffle for a garage (see regs section 32)
Comments / Championship registration numbers

Please write your Championship Registration No's and any other comments.

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.

We would also like to be allowed to pass on your Name, Address, Post Code and email addresses to [INSERT VIDEO COMPANY HERE] and [INSERT PHOTO COMPANY HERE] so that they can contact you with a view to offering you videos and photos of you on the event. If you are happy to allow us to do this, please say so here.

By clicking on the "Enter the Rally" button below you agree to the following:

Driver: "I declare that I have been given the opportunity to read the General Regulations of the Motor Sports Association and, 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 that 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."

Entrant: "I declare that to the best of my belief the driver(s) possess(es) the standard of competence necessary for an event of this type to which this entry relates and that the vehicle entered is suitable and roadworthy for the event having regard to the course and the speed that will be reached."

Driver: "I understand that should I at any time of this event be suffering from any disability whether permanent, temporary or otherwise which is likely to affect prejudicially my normal control of the vehicle, I may not take part unless I have declared such disability in writing to the Caernarvonshire and Anglesey Motor Club Ltd. I have included the entire entry fee as described in article 12 of the SR's."

 

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