De Lacy Targa Rally 2021 - Internet Entry Form

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

Welcome to the De Lacy Motor Club Targa Rally 2021

Running on Sunday 25th July 2021

Entries Close for Seeding as per the Supplementary Regulations

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

Complete all the fields in the form below. The fields with red backgrounds are mandatory. Please put TBA in any red field that you don't have the details for.

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

There are then two ways to pay:

1. Our preferred method of payment is by Bank Automated Clearing System, BACS. All fees should be paid to the following account.

De Lacy Motor Club Ltd.

Bank Sort Code: 05 05 50

Account Number: 36476539

Please endorse your payment reference with the words "Targa Rally" together with the entrant's name.

The Entry fee is £140.00

Please Note that your entry will not be confirmed until monies are received.

2. Entries may also be paid for by cheque. All cheques should be made payable to, De Lacy Motor Club Ltd. Please write entrant’s name and Targa Rally on the reverse. These should be posted to,

The Entries Secretary

Mr Ken Roberts

51 Millgate, Ackworth,

Pontefract.

WF7 7PQ

Document Addressing

E-Mail address for communication 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

Driver

Full Name This must be filled in to continue

Address You cannot sign on until this is filled in

Post Code You cannot sign on until this is filled in

Home Town You cannot sign on until this is filled in

Telephone Number You cannot sign on until this is filled in

Mobile Number You cannot sign on until this is filled in

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

Competition Licence Issuer

E-Mail Address

Club You cannot sign on until this is filled in

Invited Club details

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

I am a member of an invited club

I will require De Lacy Motor Club membership @ £10.00

Date of Birth

Nationality

Driver Publicity

Notable Results

Any other information

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 You cannot sign on until this is filled in

Post Code You cannot sign on until this is filled in

Home Town You cannot sign on until this is filled in

Telephone Number You cannot sign on until this is filled in

Mobile Number You cannot sign on until this is filled in

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

Invited Club details

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

I am a member of an invited club

I will require De Lacy Motor Club membership @ £10.00

Date of Birth

Nationality

Co-Driver Publicity

Notable Results

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

Year

Class You cannot sign on until this is filled in

ME - Modern Expert

MN - Modern Novice

HE - Historic Expert

HN - Historic Novice

Insurers

Name

I have my own Insurance

I will require REIS Insurance as arranged by the event

Address

Sponsor

Person to be contacted in case of serious accident to Driver

Name You cannot sign on until this is filled in

Address

Post Code

Telephone Number You cannot sign on until this is filled in

Relationship

Will this person be attending the event?

Person to be contacted in case of serious accident to Co-Driver

Name You cannot sign on until this is filled in

Address

Post Code

Telephone Number You cannot sign on until this is filled in

Relationship

Will this person be attending the event?

Seeding - Past Performance on Rallies

Event Name and Club

Year

Type

Overall Position

Fees - see above for how to pay

Entry Fee

£

Club Membership

£

Insurance £20

£

Breakfast at the Bolton Arms, Downholme

£

Total Money to be sent

£

Payment Method and Details This must be filled in to continue

Payment by BACS: Account details, De Lacy Motor Club Ltd - Sort Code: 05 05 50 Account Number: 36476539 - Mark payment reference with the words

Cheque made payable to De Lacy Motor Club Ltd. Endorse rear of cheque with the words

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.

No

Yes

We would also like to be allowed to pass on your Name and email address to our official photographers, If you are happy to allow us to do this, please say so here.

No

Yes

The event is not currently open for entries