Somerset Exmoor Targa 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

Address

Post Code

Home Town (Important for Media)

Telephone Number

Mobile Number

Competition Licence Number

Competition Licence Issuer & grade

E-Mail Address

Club

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

Date of Birth

Nationality

Driver & Car Commentary Info

Profession?

How Long Rallying?

History of car & any notable results?

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

Address

Post Code

Home Town (Important for Media)

Telephone Number

Mobile Number

Competition Licence Number

Competition Licence Issuer & Grade

E-Mail Address

Club

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

Date of Birth

Nationality

Co-Driver Publicity

Profession?

How Long Rallying?

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

Name

Address (if different)

Post Code

Telephone Number

Relationship

Competition Licence Issuer

Car

Make

Model

Colour

Registration Number

Engine Capacity

Year

Class You cannot sign on until this is filled in

EX1400 - Experts in cars up to 1400cc

NO1400 - Novices in cars up to 1400cc

EX1401 - Experts in cars 1401cc and over

NO1401 - Novices in cars 1401cc and over

CLUB1400 - Clubman class in cars up to 1400cc

CLUB1401 - Clubman class in cars 1401cc and over

FIA Homologated ? Yes / No

Competition Car Logbook Number You cannot sign on until this is filled in

Insurance

Insurer & Policy No.

Address.

If you wish to use the road section insurance, can you comply with the Insurance Declaration quoted in the regulations? 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

Championships

BTRDA Targa Road Rally Championship

Crew Members Registered

None

Driver

Co-Driver

Both

Driver Championship Registration Number

Co-Driver Championship Registration Number

BTRDA Allrounders Championship

Crew Members Registered

None

Driver

Co-Driver

Both

Driver Championship Registration Number

Co-Driver Championship Registration Number

ASWMC Targa Road Rally Championship

Crew Members Registered

None

Driver

Co-Driver

Both

Driver Championship Registration Number

Co-Driver Championship Registration Number

CMSGCC Targa Road Rally Championship

Crew Members Registered

None

Driver

Co-Driver

Both

Driver Championship Registration Number

Co-Driver Championship Registration Number

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 - Competitor Opinion

Out of 70 entries, where do you think you should be seeded? This must be filled in to continue

Scrutineering

If scrutineering was available in Taunton on Friday would this be of interest?

Yes

No

Fees - see above for how to pay

Entry Fee

£

Insurance

£

Sponsor a Marshal

£

Total Money to be sent

£

Marshal Details - If providing a marshal (£10 reward, see supplementary regulations)

Name

Address

Post Code

Telephone Number

Mobile Number

Email Address

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

No

Are you happy for us to send any rally documentation, including the finals, to both the driver and co driver?

Yes

No

Please provide any missing information or advise any changes by e-mail as soon as you are aware of them and as far as possible prior to arriving at the event.

By clicking on the "Enter the Rally" button below you agree to the following: "I declare that I have been given the opportunity to read the General Regulations of the Motor Sports Association and, if any, the Supplementary Regulations for this event and agree to be bound by them. I declare that I am physically and mentally fit to take part in the event and I am competent to do so. I acknowledge that I understand the nature and type of the competition and the potential risk inherent with motor sport and agree to accept that risk. Further, I understand that all persons having any connection with the promotion and/or organisation and/or conduct of the event are insured against loss or injury caused through their negligence.."