Maxus Dukeries Rally 2021 - Internet Entry Form

Entries close for seeding purposes on 7pm on Sunday 21st November. Entries finally close at 7pm on Wednesday 1st December unless we get to 100 accepted and 25 reserve entries being received at which point we will close entries regardless.

Entries Secretary: Paul Rees. 1 Sherwood Rise, Mansfield Woodhouse, Nottinghamshire. NG19 7NP. e-mail: entries@dukeries-rally.co.uk Tel 01623 404114 (Evenings after 7.00pm and before 9.00pm)

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

The Maxus Dukeries Rally - Sunday 5th December 2021 Online Entry system.

1 - Complete the mandatory fields (marked in red) in the form below, read the declaration then click the blue button to "Agree to the Declaration and Enter the Event" to initially submit your entry. You will receive an email within a few minutes telling you your entry has been received by the system.

2 - Immediately after submitting your entry, make a payment to the event for your full entry fee and any extras you have selected. There is only one way to pay - via a BACS payment. The event bank details are below:

3 - Once you have sent payment, go into your emails and find the entry received email and look for the blue link that says "Access your Entry Home Page".

4 - Please click this link and check / populate the fields marked in yellow or white on the entry form. These fields can be filled in later but any yellow ones must be populated before Saturday 27th November 2021. They will be required before you can sign-on to the event electronically.

Within 48 hours of us receiving the entry form and payment for your entry you should receive an e-mail confirming acceptance of your entry. Alternatively, if we have already received the maximum number of entries, you will be placed on the reserve entry list. You will receive an email confirming your status from the Entries Secretary.

PLEASE NOTE: WITHOUT PAYMENT YOUR ENTRY WILL NOT BE COMPLETE and you will NOT APPEAR on the LIST of PAID ENTRIES or RESERVE ENTRIES.

We will not be publishing an unseeded entry list for at least 48 hours from the entries opening time to allow us time to process payments and will not be responding to questions regarding entry status or payments until this has been published.

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@dukeries-rally.co.uk

If you are joining Dukeries Motor Club then you will need to submit payment for the club subscriptions with your entry and follow the instructions on the Dukeries MC website at https://www.dukeries-motorclub.co.uk/club-info/

Document Addressing

Whom should we send Finals and Results to? You cannot sign on until this is filled in

Driver

Co-Driver

Driver

First name and Surname (TBA / TBC not acceptable) 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

Contact Telephone Number You cannot sign on until this is filled in

Competition Licence Number This must be filled in to continue

E-Mail Address This must be filled in to continue

Club You cannot sign on until this is filled in

Club Membership No

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 (per K10.3.1) 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 (per K10.3.1) 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

First name and Surname (TBA / TBC not acceptable) 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

Contact Telephone Number You cannot sign on until this is filled in

Competition Licence Number This must be filled in to continue

E-Mail Address This must be filled in to continue

Club You cannot sign on until this is filled in

Club Membership No

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 (per K10.3.1) 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 (per K10.3.1) 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 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

Additional Person 1

Name of first additional person / service crew (Please put None if not attending) You cannot sign on until this is filled in

Mobile Number of first additional person / service crew (Please put None if not attending) You cannot sign on until this is filled in

Additional Person 2

Name of second additional person / service crew (Please put None if not attending) You cannot sign on until this is filled in

Mobile Number of second additional person / service crew (Please put None if not attending) You cannot sign on until this is filled in

Additional Person 3

Name of third additional person / service crew (Please put None if not attending) You cannot sign on until this is filled in

Mobile Number of third additional person / service crew (Please put None if not attending) You cannot sign on until this is filled in

Additional Person 4

Name of fourth additional person / service crew (Please put None if not attending) You cannot sign on until this is filled in

Mobile Number of fourth additional person / service crew (Please put None if not attending) You cannot sign on until this is filled in

Sponsor

Sponsor Names (Note: this sponsor does not need an entrant's licence). Please only list 3 sponsors maximum!

Bank	Co-operative Bank
Sort Code	08-92-99
Account No.	65342240
Account Name:	Dukeries MC Events Account
Reference	Driver's First name and Surname

Maxus Dukeries Rally 2021 - Internet Entry Form

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