Roberts Garages Jersey Rally 2024 - Internet Entry Form

 

Entries Secretary:

Angie Renouf
61 Marett Court
Marett Road
St Helier
JE2 4PZ
Telephone 01534 862375

e-mail: jerseyrally@jerseymotorsport.com

Date: 11th & 12th October 2024

Permit Number: 

This Event is held Under the General Regulations of Motorsport UK (incorporating the provisions of the International Sporting Code of the FIA) the Standing Competition Rules and Supplementary Regulations of the Club. 

Welcome to Jersey Motorcycle and Light Car Club Online Entry system. Please follow the steps below to enter the event.

Complete all the fields in the form below.

The fields with red backgrounds are mandatory.

Once you have hit the "Enter Event" button at the end you will receive an automated response confirming we have received your entry form.

There are two ways to pay

1) If you would like to pay via credit or debit card, you will get a link after submitting your entry. Please be aware that you will be charged a 3.5% surcharge to pay via PayPal, this is to cover the PayPal fees.

2) Payment can also be made by cheque

 

Within 3 days of us receiving the payment for your entry you should receive an e-mail confirming reciept of your entry from the Entries Secretary


NOTE: WITHOUT PAYMENT YOUR ENTRY WILL NOT BE VALID. If you don't receive a response within 5 days of the expected payment date, or if you have any other questions, please e-mail the entries secretary at the address above.

 

Contact Information
Driver
Driver Media Information
Driver's Parent or Guardian (under 18 only)
NOTE: Parent or Guardian MUST sign on.
Co-Driver
Co-Driver Media Information
Co-Driver's Parent or Guardian (under 18 only)
NOTE: Parent or Guardian MUST sign on.
Competing Car
Road Insurers
Service Vehicle
Person to be contacted in case of serious accident to Driver
Person to be contacted in case of serious accident to Co-Driver
Seeding - Performance on Rallies in the last 5 years
Event Name and Club
Year
Status
Surface
Overall Position

Class Position

Seeding - Competitor Opinion
Fees - see above for how to pay
£
£
£
£
£
Entrant (if applicable and not driver)
Tourism Information (This is important in order for the event to maintain support from the local authorities)
Privacy and Permissions

By entering the rally you are accepting these terms:

We take your privacy seriously and will only use your personal information to administer your entry, including providing a public Entry / Results 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.

 Remember your entry is subject to receipt of the correct entry fee. 

Entry Declaration:

I declare that I have been given the opportunity to read the General Regulations of Motorsport UK 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 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.

By entering this rally competitors will be abiding by the JMC & LCC’s Child Protection & Safeguarding policies which can be found on the club website

“I declare that the use of the vehicle hereby entered will be covered by insurance as required by the law which is valid for such part of this event as shall take place on road as defined by the law”.

I understand that should I at the time of this event be suffering from any disability whether permanent of temporary which is likely to affect prejudicially my normal control of my vehicle. I may not take part unless I have declared such disability to the ASN which has, following such declaration, issued a licence which permits me to do so.

I declare the statements given in the entry form are correct as verified by me.