John Overend Memorial Stages Rally 2019

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

How would you like to receive Finals and Results?

E-mail/Website

Posted Paper

Driver

Full Name This must be filled in to continue

Address

Post Code

Home Town

Telephone Number

Mobile Number

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

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)

Helmet Make You cannot sign on until this is filled in

Helmet Model You cannot sign on until this is filled in

Helmet Approval Standard You cannot sign on until this is filled in

FHR Make You cannot sign on until this is filled in

FHR Model You cannot sign on until this is filled in

FHR Approval Standard You cannot sign on until this is filled in

Driver's Parent or Guardian (under 18 only)

Name

Address (if different)

Post Code

Telephone Number

Relationship

Competition Licence Number

Competition Licence Issuer

Co-Driver

Full Name This must be filled in to continue

Address

Post Code

Home Town

Telephone Number

Mobile Number

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

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)

Helmet Make You cannot sign on until this is filled in

Helmet Model You cannot sign on until this is filled in

Helmet Approval Standard You cannot sign on until this is filled in

FHR Make You cannot sign on until this is filled in

FHR Model You cannot sign on until this is filled in

FHR Approval Standard You cannot sign on until this is filled in

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

Name

Address (if different)

Post Code

Telephone Number

Relationship

Competition Licence Issuer

Car

Make You cannot sign on until this is filled in

Model You cannot sign on until this is filled in

Colour

Registration Number

Engine Capacity (in cc)

Year

Forced Induction or Rotary engine

No

Yes

Four Wheel Drive

No

Yes

Class You cannot sign on until this is filled in

1 - Cars up to 1000cc

2 - Cars 1001cc up to 1400cc

3 - Cars 1401cc up to 1600cc

4 - Cars 1601cc up to 2000cc

5 - Cars 2001cc and over

6 - All 4 wheel drive cars

7 - All Historic Rally cars in categories 1, 2 and 3, complying with Motorsport UK specific regulation R49

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

Car Seats and Harnesses

Left Harness FIA Homologation Expiry Date You cannot sign on until this is filled in

Right Harness FIA Homologation Expiry Date You cannot sign on until this is filled in

Left Seat FIA Homologation Expiry Date You cannot sign on until this is filled in

Right Seat FIA Homologation Expiry Date You cannot sign on until this is filled in

Car Fire Extinguishers

Hand-held fire extinguisher make You cannot sign on until this is filled in

Hand-held fire extinguisher capacity You cannot sign on until this is filled in

Hand-held fire extinguisher last service date You cannot sign on until this is filled in

Plumbed-in fire extinguisher make You cannot sign on until this is filled in

Plumbed-in fire extinguisher capacity You cannot sign on until this is filled in

Plumbed-in fire extinguisher last service date You cannot sign on until this is filled in

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.

Eligibility

The 2019 Roadrunner Phoenix Awards ANEMMC Stage Rally Championship

Crew Members Registered

None

Driver

Co-Driver

Both

The Wemix Concrete Ltd EMAMC Stage Rally Championship 2019

Crew Members Registered

None

Driver

Co-Driver

Both

The ANWCC Stage Rally Championship 2019

Crew Members Registered

None

Driver

Co-Driver

Both

The Yokohama Tyres Senior F1000 Championship 2019

Crew Members Registered

None

Driver

Co-Driver

Both

The 2019 Melbourne Challenge

Crew Members Registered

None

Driver

Co-Driver

Both

North Humberside Motor Club Crew award (see S/R 13 for eligibility)

Crew Members Registered

None

Driver

Co-Driver

Both

Mixed Crew Award

Crew Members Registered

None

Driver

Co-Driver

Both

Female Driver Award

Crew Members Registered

None

Driver

Co-Driver

Both

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 Club

Year

Type

Surface

Overall Position

Position in Class

Seeding - Competitor Opinion

Out of 70 entries, where do you think you should be seeded?

Scrutineering

When would you prefer to scrutineer?

Saturday 11th May - 16:00 to 18:30

Sunday 12th May - 06:00 to 08:00

Fees - see above for how to pay

Entry Fee

£

Club Membership

£

Phil & Marcus Andrews Photo Offer @ £12.00 (see SR32)

£

Donation to the Marshals Fund

£

Total Money to be sent

£

Payment Method and Details (Scheme A (Cheque) or Scheme B (Direct BACS transfer) - see above) This must be filled in to continue

Scheme A (Cheque)

Scheme B (BACS transfer)

Entrant (if applicable and not driver)

Name

Address

Post Code

Telephone Number

Nationality

Motorsport UK Competition Licence Number

Club Membership No

Marshal Details - if you know of a marshal who'd like to come and help, please give details here

Name

Address

Post Code

Telephone Number

Mobile Number

Email Address

Experience

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.

Yes

No

We would also like to be allowed to pass on your Name, Address, Post Code and email addresses to MAD Video Productions (Official Video) and Phil and Marcus Andrews (Official Photographer) 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.

Yes

No

The event is not currently open for entries

John Overend Memorial Stages Rally 2019 - Internet Entry Form

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