Chris Hellier Rally Sponsored by Greenway Garage & Carwyn Jones Carpentry - Internet Entry Form

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

Kirsty Rooke

Bron Y Gan

Swyddffynnon

Ystrad Meriug

SY25 6Al

Telephone: 01974 831067/ 0796769716

e-mail: barcudmotorclub@hotmail.com

Held under the General Regulations of the Motor Sports Association (incorporating the International Sporting Code of the FIA) and the Supplementary Regulations

Welcome to Chris Hellier Memorial Rally Online Entry system.

PLEASE ENSURE YOU HAVE READ THROUGH THE REGS THOROUGHLY! BEFORE YOU FILL IN THE ENTRY FORM

Please follow the steps below to enter the rally.

Complete all the fields in the form below. The fields with red backgrounds are mandatory.

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 you can pay:- Please State Your Name If paying on BACS or if paying by cheque please state both drivers and navigators name on the back.

Remember there is 2 ways you can payYou can send a cheque,(when you enter!!) made payable to Barcud Motor Club to the Entries Secretary at the address above

BACS you can pay through bank transfer.

Sort Code: 20-18-41 Account Number:60409789

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 barcudmotorclub@hotmail.com

All the fields with a red background must be filled in, or you will not be able to continue.

Please put TBA in any red field which you do not know the details for. (but send them as soon as you do!!)

At signing on incomplete entry forms will be handed back to you to be filled out at the back of the queue!

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

Post Code

Telephone Number

Mobile Number

E-Mail Address

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

Date of Birth

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

Post Code

Telephone Number

Mobile Number

E-Mail Address

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

Date of Birth

Co-Driver's Parent or Guardian (under 18 only)

Name

Address (if different)

Post Code

Telephone Number

Relationship

Competition Licence Number

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

1 - Expert

2 - Semi Expert

3 - Novice

Insurers

Name & policy No

Address

Person to be contacted in case of serious accident to Driver

Name

Address

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

Address

Post Code

Telephone Number

Relationship

Will this person be attending the event?

Seeding - Past Performance on Rallies

Event Name and Club

Year

Overall Position

Fees - see above for how to pay

Entry Fee £110.00

Club Membership

Total Money to be sent

Payment Method and Details This must be filled in to continue

Marshal Details

Name

Mobile Number

Experience

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

The event is not currently open for entries