Roger Albert Clark Rally 2021 - Internet Entry Form

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

Entries Secretary:

Victoria Heppenstall

2 Monroe Avenue

Lindsayfield

East Kilbride

G75 8WA

Telephone: (H) 01355 276483
E-Mail: entries.r.a.c@gmail.com

Welcome to the Roger Albert Clark Rally, 25th to 29th November 2021

Seeding will take place on 1st November 2021, Entries Close at 12:00 on 10th November 2021. Late entries will be accepted at the organisers discretion

Held under the General Regulations of Motorsport 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 we have received your entry form.

There are then two ways to pay:

1. You can send a cheque, made payable to 'Roger Albert Clark Rally Motor Club Ltd' to the Entries Secretary at the address above. Please include drivers full name on back of cheque . Competitors wishing to pay by cheque can do so in full or please refer to Article 8.11 of the regulations for staged payments. Cheques should reach the Entries Secretary within 5 days of the entry being made and no later than Wednesday 10th November 2021.

2. Competitors wishing to make direct payments into the bank should use the following account details:

Sort Code 80-12-08 Account Number 06002797 Reference should contain the drivers full name.

Within 24 - 48 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 OF THE ENTRY FEE OR ENTRY DEPOSIT YOUR ENTRY WILL NOT BE VALID.

If you don't receive a response within 3 - 4 days of the expected payment date, or if you have any other questions, please e-mail entries.r.a.c@gmail.com

Competition Licences must be obtained from the Motorsport UK prior to the event. Licence applications cannot be accepted at documentaion

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

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

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

Date of Birth

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 (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 Publicity

Hobbies

Married?

No of Children

How Long Rallying?

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

Competition Licence Issuer

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

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 (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 Publicity

Hobbies

Married?

No of Children

How Long Rallying?

Notable Results

Any other information

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

Insurers

Name

Address

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

Surface

Overall Position

Class Position

Fees - see above for how to pay

Entry Fee

£

Club Membership

£

Insurance

£

Full Set of Event Maps

£

Additional 1:25,000 Stage Maps

£

Additional 1:50,000 Competitor Overview Maps

£

Additional Service Overview Maps

£

Management Pack (Maximum of two)

£

Support Vehicle

£

Donation to Marshals £? up to you.

£

Total Money to be sent

£

Payment Method and Details This must be filled in to continue

Cheque made Payable to 'Roger Albert Clark Rally Motor Club' Please write drivers full name on the back.

Bank transfer to, Sort Code 80 - 12 - 08 Account Number 06002797, Reference should contain the drivers full name

Entrant (if applicable and not driver)

Name

Address

Post Code

Telephone Number

Nationality

Competition Licence Number

Competition Licence Issuer

Club Membership No

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.

No

Yes

The event is not currently open for entries