Keith Frecker Memorial Weeton Stages 2018 Internet Entry Form

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

Entries Close on-line 30th May 2018 at 23.59 after this time please email or phone the secretary

Secretary: 

Dave Benson 07918 023920 davidrbenson@virginmedia.com

If paying by cheque please send to David Benson, 80 Annesley Ave, Layton, Blackpool, FY37HX

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

Welcome to the Keith Frecker Memorial Weeton Stages & Junior Stages Rally 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 then two ways to pay
    1. If you have internet or telephone banking, you can arrange for the fees to be paid directly into our account. The details are:-
      Bank Royal Bank of Scotland
      Sort Code  16-13-29
      Account No.  10123568
      Account Name BSSMC Limited
      Reference Driver's full name.
    2. You can send a cheque made payable to 'BSSMC Limited' to the Entries Secretary at the address above. Entries after 30th May 2018 must be paid either on-line or CASH (no cheques).
  4. As soon as possible after 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 do not receive a response within 3 days of the expected payment date, or if you have any other questions, please e-mail davidrbenson@virginmedia.com
  6. All the fields with a red background must be filled in, or you will not be able to continue. Please put TBA in any red field which you do not know the details for.
Document Addressing
E-Mail address for communication
Real Name of this person
Driver
Full Name
Address
Post Code
Home Town
Telephone Number
Mobile Number
Competition Licence Number
E-Mail Address
Club
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
E-Mail Address
Club
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
FIA Fuel?
Forced Induction
Four Wheel Drive
Class
In Car Camera Request
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
Formula 1000 Championship
Crew Members Registered
Driver Championship Registration Number
Co-Driver Championship Registration Number
The Association of North Western Car Clubs
Crew Members Registered
Driver Championship Registration Number
Co-Driver Championship Registration Number
The SD34 MSG Stage Rally 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 and ClubYearTypeSurfaceOverall PositionNo of Starters
Seeding - Competitor Opinion
Out of 60 entries, where do you think you should be seeded? (45 Senior entries 15 Junior entries)
Fees - see above for how to pay
Entry Fee £
Club Membership £
Total Money to be sent£
Payment Method and Details
Entrant (if applicable and not driver)
Name
Address
Post Code
Telephone Number
Nationality
Competition Licence Number
Competition Licence Issuer
Marshal Details
Name
Address
Post Code
Telephone Number
Mobile Number
Email Address
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.

We would also like to be allowed to pass on your Name, Address, Post Code and email addresses to our official event photographer and video company 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.

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.."

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