Hills Ford Stages 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

Post Code

Home Town

Telephone Number

Mobile Number This must be filled in to continue

Competition Licence Number This must be filled in to continue

Competition Licence Issuer

E-Mail Address

Club - See Article 7 (Competitor Eligibility) in the SRs. You cannot sign on until this is filled in

Club Membership No

Date of Birth This must be filled in to continue

Nationality

Driver Publicity

Other hobbies / Interesting facts (to make the commentary more interesting!) You cannot sign on until this is filled in

How long have you been 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

Post Code

Home Town

Telephone Number

Mobile Number This must be filled in to continue

Competition Licence Number This must be filled in to continue

Competition Licence Issuer

E-Mail Address

Club - See Article 5.3 (Competitor Eligibility) in the regs. You cannot sign on until this is filled in

Club Membership No

Date of Birth This must be filled in to continue

Nationality

Co-Driver Publicity

Hobbies / Interesting facts (to make the commentary more interesting!) You cannot sign on until this is filled in

How long have you been 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

Make This must be filled in to continue

Model This must be filled in to continue

Colour

Registration Number This must be filled in to continue

Engine Capacity You cannot sign on until this is filled in

Year

Forced Induction This must be filled in to continue

No

Yes

Four Wheel Drive

No

Yes

In Car Camera Request

Yes

No

If you are NOT purchasing event road section insurance (SR21) you MUST PROVIDE DETAILS of your own competition road section insurance

Insurer name & Policy No This must be filled in to continue

If not purchasing event road section insurance, please enter your own insurance company address for your road section cover. If you are purchasing the event cover, you may type 'Event' in the box below This must be filled in to continue

If you are purchasing the event road section insurance (REIS), can you comply with the Insurance Declaration quoted in the regulations? SR21 This must be filled in to continue

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

No - I wish to use the REIS insurance but do not comply (Driver must contact Entry Secretary and REIS to apply)

N/A - I have my own insurance and have provided the insurance company details

Recce Vehicle

Make

Model

Colour

Registration Number You cannot sign on until this is filled in

Contact Name

Contact Number

Service Vehicle

Make

Model

Colour

Registration Number You cannot sign on until this is filled in

Contact Name

Contact Number

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

Motorsport UK Protyre Asphalt Championship

Crew Members Registered

None

Driver

Co-Driver

Both

Driver Championship Registration Number

Co-Driver Championship Registration Number

HRCR Stage Masters Challenge

Crew Members Registered

None

Driver

Co-Driver

Both

Driver Championship Registration Number

Co-Driver Championship Registration Number

The HRCR Mini Cup

Crew Members Registered

None

Driver

Co-Driver

Both

Driver Championship Registration Number

Co-Driver Championship Registration Number

Cotswold Motorsport Group Stage Rally

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 This must be filled in to continue

Address

Post Code

Telephone Number This must be filled in to continue

Relationship

Will this person be attending the event?

Person to be contacted in case of serious accident to Co-Driver

Name This must be filled in to continue

Address

Post Code

Telephone Number This must be filled in to continue

Relationship

Will this person be attending the event?

Seeding - Past Performance on Rallies

If you leave this section blank, you may be disappointed with your seeding!

Event Name and Club

Year

Type

Surface

Overall Position

No of Starters

Scrutineering and Reconnaissance

When would you prefer to scrutineer? Only Saturday is available now.

Saturday 14th 08:00 to 14:00

Participating in Recce?

Yes Friday Only

Yes Saturday Only

Yes Friday and Saturday

No

Fees - all payments must be by BACS

Entry Fee

£

Club Membership

£

Insurance

£

Donation to the Marshal Fund

£

Total Money to be sent

£

Payment Details

Sort Code 60-05-16

Account Number 19540124

Account Name Cheltenham Motor Club

Please user driver surname and initial as the reference

BACS As per SR14.10

Entrant (if applicable and not driver)

Name

Address

Post Code

Competition Licence Number

Competition Licence Issuer

Comments

Anything else you'd like to tell us?

To help us quickly match your entry fee payment to the your entry form, please enter the name of the bank account you will be paying from. Especially if it is different to your Driver / CoDriver surname, (e.g. sponsor name or company name)

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

We would also like to be allowed to pass on your Name, Address, Post Code and email addresses to any official photographers or videographers attending the event so that they can contact you with a view to offering you videos and photos of you on the event. If you are happy to allow us to do this, please say so here.

Yes

No

The event is not currently open for entries

Hills Ford Stages 2024 - Internet Entry Form

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