Mike Hart Targa Rally 2024 - Internet Entry Form

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.

If you have internet or telephone banking, you can arrange for the fees to be paid directly into our account. The details are:-

NOTE: WITHOUT PAYMENT YOUR ENTRY WILL NOT BE VALID Within 24 hours of us receiving the payment for your entry you should receive an e-mail confirming your entry from Barrie.

If you don't receive a response within 3 days of the expected payment date, or if you have any other questions, please email bazpott1966@gmail.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!!)

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

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

E-Mail Address

Club You cannot sign on until this is filled in

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

Driver's Parent or Guardian (under 18 only)

Name

Address (if different)

Post Code

Telephone Number

Relationship

Competition Licence Number

Co-Driver

Full Name This must be filled in to continue

Address

Post Code

Telephone Number

Mobile Number

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

E-Mail Address

Club You cannot sign on until this is filled in

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

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

Name

Address (if different)

Post Code

Telephone Number

Relationship

Competition Licence Number

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

Class You cannot sign on until this is filled in

E - Expert

S - Semi Expert

N - Novice

Insurers

Name

Address

Policy Number You cannot sign on until this is filled in

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

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

Overall Position

Fees - see above for how to pay

Entry Fee

Club Membership

Insurance

Total Money to be sent

Payment Method and Details This must be filled in to continue

Marshal Details

Name

Address

Post Code

Telephone Number

Mobile Number

Email Address

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

We would also like to be allowed to pass on your Name, Address, Post Code and email addresses to [INSERT VIDEO COMPANY HERE] and [INSERT PHOTO COMPANY HERE] 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

The event is not currently open for entries

Bank	Barclays
Sort Code	206108
Account No.	13107663
Account Name	Knighton Motor Club Limited
Reference	Drivers Name

Mike Hart Targa Rally 2024 - Internet Entry Form

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