Maple Garage Beaver Rally 2024 - Internet Entry Form

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

Driver

Full Name This must be filled in to continue

Address You cannot sign on until this is filled in

Post Code

Mobile Number

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

Driver's Parent or Guardian (under 18 only)

Name

Address (if different)

Post Code

Telephone Number

Relationship

Navigator

Full Name This must be filled in to continue

Address You cannot sign on until this is filled in

Post Code

Mobile Number

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

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 You cannot sign on until this is filled in

Engine Capacity

Class You cannot sign on until this is filled in

E - Expert

S - Semi Expert

N - Novice

C - Clubman

Insurers

Name You cannot sign on until this is filled in

Address You cannot sign on until this is filled in

If you wish to purchase additional Road Section cover, can the driver comply with the following?

is aged 19 years or over
has held a full driving licence for a minimum of 6 months
has no more than 6 points on their licence
has had no more than 1 fault claim in the last 3 years
is a named driver on a valid motor insurance policy for the vehicle they are driving
do not have the Third-Party Extension cover on their existing motor policy
the vehicle has a valid MOT and taxed for the road, unless exempt from doing so

You cannot sign on until this is filled in

Yes - I wish to use the insurance and I comply with all points

No - I wish to use the insurance but do not comply (please contact me)

N/A - I have my own insurance

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.

Championships

ANCC - Blacker Automotive Road Rally Championship

Crew Members Registered

None

Driver

Co-Driver

Both

The Clubman Motorsport EMAMC Road Rally Championship

Crew Members Registered

None

Driver

Co-Driver

Both

The Drury Deliveries ANEMMC Road Rally Championship 2024

Crew Members Registered

None

Driver

Co-Driver

Both

ANWCC - Road & Navigation Rally Championship

Crew Members Registered

None

Driver

Co-Driver

Both

SD34 Road Rally Championship

Crew Members Registered

None

Driver

Co-Driver

Both

Person to be contacted in case of serious accident to Driver

Name You cannot sign on until this is filled in

Address You cannot sign on until this is filled in

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 You cannot sign on until this is filled in

Address You cannot sign on until this is filled in

Post Code

Telephone Number

Relationship

Will this person be attending the event?

Seeding - Past Performance on Road Rallies

Event Name and Club

Year

Overall Position

No of Starters

Seeding - Competitor Opinion

Out of 50 entries, where do you think you should be seeded?

Fees - see above for how to pay

Entry Fee

£

Insurance

£

Driver's Beverley & DMC Club Membership

£

Navigator's Beverley & DMC Club Membership

£

Optional Donation to the Marshal Fund

£

Total Money to be sent

£

Entrant (if applicable and not driver)

Name

Address

Post Code

Telephone Number

Competition Licence Number

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, which is rallies.info.You can find out how Beverley & District Motor Club processes your information by reading our privacy policy, and you can also see how rallies.info process your information on their privacy policy

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

The event is not currently open for entries

Maple Garage Beaver Rally 2024 - Internet Entry Form

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