Shaw Trophy Targa Rally 2018 Internet Entry Form

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

Entries Close for seeding on 2nd June 2018 at 12.00 pm

Entries Secretary: Gordon Bradford
13 Beverley Drive, Swalwell, Newcastle upon Tyne, NE16 3EH

Telephone 07412 107269

e-mail:entries@shawtrophy.co.uk

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 Shaw Trophy Targa Rally Online Entry system

Please follow the steps below to enter the rally.

Complete all the fields in the form below. The fields with red backgrounds are mandatory.

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.

There are three ways to pay

If you have internet or telephone banking, you can arrange for the fees to be paid directly into our account. The details are:-


Sort Code	20 58 17
Account No.	50889318

Reference	Driver's Name

- Cheque made payable to Whickham & District Motor Club to the Entries Secretary at the address above (No Cheque entries accepted after 2nd June 2018, post dated cheques are not accepted.)

- Cash at a club night.

***Please be aware that your entry will not be accepted UNTIL PAYMENT IN FULL HAS BEEN RECEIVED and cleared.***

If you don't receive a response within 3 days of the expected payment date, or if you have any other questions, please e-mail entries@shawtrophy.co.uk

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 (but send them as soon as you do!)

Document Addressing

E-Mail address for communication

Real Name of this person

Whom should we send Finals and Results to?

Driver
Co-Driver

Driver

Full Name

Address

Post Code

Telephone Number

Mobile Number

E-Mail Address

Club

Date of Birth

Driver's Parent or Guardian (under 18 only)

Name

Address (if different)

Post Code

Telephone Number

Relationship

Navigator

Full Name

Address

Post Code

Telephone Number

Mobile Number

E-Mail Address

Club

Date of Birth

Navigator'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

Non Compliant Historic Car

Please tick the box if your car does NOT comply with Road Rally Regs 18.2.1 - 18.2.4 ie more than 2 cams/2 chokes/more than 4 cyls

No
Yes

Class

ME - Modern Experts
MN - Modern Novices
HE - Historic Experts
HN - Historic Novices

FIA Homologation Number

INSURANCE If you wish to use our Insurance state "Event Insurance" if you have you own please state the name & address of the Insurance company

Name

Address

Marshal Car Information

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?

Yes
No

Person to be contacted in case of serious accident to Navigator

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	Overall Position	No of Starters

Fees - see above for how to pay

Entry Fee

Club Membership

Insurance

Total Money to be sent

Payment Method and Details

Marshal Details

Name

Address

Post Code

Telephone Number

Mobile Number

Email Address

Experience

Comments

Anything else you'd like to tell us

The details on this form will be held on computer in order to be used for the administration of this event. They will also be used to send you information about future events organised by this club, unless you untick this box to indicate you do not wish to receive information on further events.
The details on this form may also be passed on to other motorsport organisations, unless you untick this box to indicate you do not wish these details passed on.

Remember your entry is subject to receipt of the correct entry fee and all requested information. 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 consent to the organising committee using the information I have given for the purpose of displaying relevant details on an entry list to be made available to the public via written and electronic means, and for mailings to promote future editions of the Shaw Trophy Targa Rally. The information provided will be treated in confidence and will be held in compliance with the Data Protection Act 1998. Crews personal details will be shared with members of the Rally and Whickham & District Motor Club Committees and address labels/email addresses for the purposes of distributing Press Releases and advertising their services. I understand you cannot verify that the Official Photographers/Media will not share such information with other organisations or individuals.

MSA Indemnity

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

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. I understand that motorsport is dangerous and accidents causing death, injury, disability and property damage can and do happen. I understand that these risks may give rise to my suffering personal injury or other loss and I acknowledge and accept these risks.
To the best of my belief the driver(s) possess(es) the standard of competence necessary for an event of the 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 speeds which will be reached.
The use of the vehicle hereby entered is covered by insurance as required by the law, which is valid for such part of this event as shall take place on roads as defined by the law.
I understand that should I, at the time of this event, be suffering from any disability whether permanent or temporary which is like to affect prejudicially my normal control of the vehicle, I may not take part unless I have declared such disability to the Royal Automobile Club Motor Sports Association Ltd which has, following such declaration, issued a licence which permits me to do so.
Any application form for a licence which was signed by a person under the age of 18 years was countersigned by that person's parent/legal guardian/guarantor, whose full names and addresses have been given.
If I am the Parent/Guardian/Guarantor of the driver/co-driver I understand that I shall have the right to be present during any procedure being carried out under the Supplementary Regulations issued for this event and the General Regulations of the MSA. As the Parent/Guardian/Guarantor I confirm that I have acquainted myself with the MSA General Regulations, agree to pay any appropriate charges and fees pursuant to those Regulations (to include any appendices thereto) and hereby agree to be bound by those Regulations and submit myself without reserve to the consequences resulting from those Regulations (and any subsequent alteration thereof). Further, I agree to pay as liquidated damages any fines imposed upon me up to the maxima set out in Part 3, Appendix 1. NB. Where the Parent/Guardian/Guarantor is not present there must be a representative who must produce a written and signed authorisation to so act from the Parent/Guardian/Guarantor as appropriate.
I hereby agree to abide by the MSA Child Protection Policy and Guidelines and the National Sporting Code of Conduct.
I undertake that at the time of the event to which this entry relates I shall have passed or am exempt from an ASN specified medical examination within the specified period (H10.1.6).
I have read and fully understood the Procedure for Control of Drugs and Alcohol as contained in the Competitors and Officials Yearbook Regulations H39, D35.1, G15.1.14 and have also familiarised myself with the information on the websites referred to (www.ukad.org.uk and www.wada-ama.org) in particular the UK Anti-Doping Rules which have been adopted by the MSA (as amended). Further, if i am countersigning at the Parent/Guardian/Guarantor of a minor then in addition to the deemed consent to the testing of that minor (Art 5.6.2) I hereby confirm that I give such consent for the minor concerned to be so tested.

In consideration of the acceptance of this entry, I agree that neither any one or of any combination of the MSA and its associated clubs, the organisers, the land owners or other occupiers, the promoters and their respective officers, servants, representatives and agents ('the Parties') shall have any liability for loss or damage which may be sustained or incurred by me as a result of participation in the event. Nothing in this clause is intended to or shall be deemed to exclude or limit liability for death or personal injury. To the fullest extent permitted by law I agree to indemnify and hold harmless each of the Parties in respect of any loss or damage whatsoever and howsoever arising from my participation in this event.

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