Santa Pod Winter Nationals 2019 - Internet Entry Form

Welcome to Jersey Motorcycle and Light Car Club Online Entry system. Please follow the steps below to enter the event.

Once you have hit the "Enter Event" button at the end you will receive an automated response confirming we have received your entry form.

1) If you would like to pay via credit or debit card, you will get a link at this point to take you to Paypal's website.

Within 24 hours 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. 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 the entries secretary Lawra Traylen at the address above.

Contact Infromation

E-Mail address for communication This must be filled in to continue

Contact Name This must be filled in to continue

Driver

Full Name This must be filled in to continue

Address This must be filled in to continue

Post Code This must be filled in to continue

Home Town

Telephone Number This must be filled in to continue

Mobile Number This must be filled in to continue

Motorsport UK Licence Number This must be filled in to continue

Competition Licence Issuer

Yes

E-Mail Address This must be filled in to continue

Club You cannot sign on until this is filled in

Jersey Motorcycle and Light Car Club

Jersey Kart Club

Jersey Classic and Vintage Motor Racing Club

Guernsey Kart and Motor Club

Guernsey MC & CC

Club Membership No You cannot sign on until this is filled in

Date of Birth (if under 18 years of age)

Nationality

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

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

Person to be contacted in case of serious accident to Driver

Name This must be filled in to continue

Address

Post Code

Telephone Number This must be filled in to continue

Relationship

Will this person be attending the event?

Fees - see above for how to pay

Entry Fee

Pit Loo

Additional Pit Space

Total Money to be sent

Payment Method This must be filled in to continue

PayPal

Entrant (if applicable and not driver)

Club Membership No

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

Please ignore this question

Yes

The event is not currently open for entries

Santa Pod Winter Nationals 2019 - Internet Entry Form

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