Jim Clark 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

Whom should we send Finals and Results to?

Driver

Co-Driver

How would you like to receive Finals and Results?

E-mail/Website

Driver

Full Name This must be filled in to continue

Address

Post Code

Home Town

Telephone Number

Mobile Number

Competition Licence Number You cannot sign on until this is filled in

Competition Licence Issuer

E-Mail Address

Club or Championship You cannot sign on until this is filled in

Club Membership No. or Championship Registration No. You cannot sign on until this is filled in

Date of Birth

Nationality

Driver Publicity

Hobbies

Married?

No of Children

How Long Rallying?

Notable Results

Any other information

Driver's Parent or Guardian (under 18 only)

Name

Address (if different)

Post Code

Telephone Number

Relationship

Co-Driver

Full Name This must be filled in to continue

Address

Post Code

Home Town

Telephone Number

Mobile Number

Competition Licence Number You cannot sign on until this is filled in

Competition Licence Issuer

E-Mail Address

Club or Championship You cannot sign on until this is filled in

Club Membership No, or Championship Registration No. You cannot sign on until this is filled in

Date of Birth

Nationality

Co-Driver Publicity

Hobbies

Married?

No of Children

How Long Rallying?

Notable Results

Any other information

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

Name

Address (if different)

Post Code

Telephone Number

Relationship

Car

Make This must be filled in to continue

Model This must be filled in to continue

Colour

Registration Number

Engine Capacity

Year

Forced Induction

No

Yes

Four Wheel Drive

No

Yes

Class This must be filled in to continue

1 - 2wd Cars up to 1400cc

2 - 2wd Cars 1401cc to 1600cc including FIA Rally 5 cars

3 - 2wd Cars 1601cc - 2000cc and FIA Rally 4 cars

4 - over 2000cc two-wheel drive cars including all FIA R3T cars

5 - All 4 wheel Drive Cars (other than those in Class 6 below)

6 - Homologated or Non-Homologated current or former WRC cars, current or former S2000 cars and all FIA R5 cars, or derivatives of these cars

7 - Historic Vehicles complying with R49

8 - AFRT Land Rovers and Invited Land Rovers

In Car Camera Request

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

Insurers

Insurance You cannot sign on until this is filled in

I wish to use REIS Insurance

I am using my own insurance

State Name of Insurer, only if using your OWN Insurance

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

Service Vehicle

Make

Model

Colour

Registration Number

Contact Name

Contact Number

Championships

Probite British Rally Championship

Crew Members Registered

None

Driver

Co-Driver

Both

Driver Championship Registration Number

Co-Driver Championship Registration Number

Protyre Motorsport UK Asphalt Championship

Crew Members Registered

None

Driver

Co-Driver

Both

Driver Championship Registration Number

Co-Driver Championship Registration Number

AS Performance North of England Tarmacadam Championship

Crew Members Registered

None

Driver

Co-Driver

Both

Driver Championship Registration Number

Co-Driver Championship Registration Number

ANECCC S G Petch Stage Rally Championship

Crew Members Registered

None

Driver

Co-Driver

Both

Driver Championship Registration Number

Co-Driver Championship Registration Number

Armed Forces Rally Team 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 - Past Performance on Rallies

Event Name and Club

Year

Type

Surface

Overall Position

No of Starters

Seeding - Competitor Opinion

Out of 100 entries, where do you think you should be seeded?

Scrutineering

When would you prefer to scrutineer?

Fees - see above for how to pay

Entry Fee

£

Insurance

£

Entry Fee for Shakedown Stage

£

Contribution to Marshals fund

£

Optional Carbon Offset charge

£

Total Money to be sent

£

Entrant (if applicable and not driver)

Name

Address

Post Code

Telephone Number

Nationality

Competition Licence Number

Competition Licence Issuer

Club Membership No

Comments

Do you have any specific service area requests? Anyone you need to service beside? If none please type 'nil' You cannot sign on until this is filled in

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

The event is not currently open for entries

Jim Clark Rally 2024 - Internet Entry Form

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