Border 100 Road Rally 2025 - 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 This must be filled in to continue

Post Code This must be filled in to continue

Mobile Number This must be filled in to continue

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

E-Mail Address This must be filled in to continue

Club You cannot sign on until this is filled in

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

Date of Birth

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 This must be filled in to continue

Post Code This must be filled in to continue

Mobile Number This must be filled in to continue

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

E-Mail Address This must be filled in to continue

Club You cannot sign on until this is filled in

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

Date of Birth

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

Name

Address (if different)

Post Code

Telephone Number

Relationship

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 (Expert / Semi-Expert / Novice) You cannot sign on until this is filled in

E - Expert

S - Semi - Expert

N - Novice

Insurers

Name

Address

Championships

Welsh Border Car Club

Crew Members Registered

None

Driver

Co-Driver

Both

Driver Championship Registration Number

Co-Driver Championship Registration Number

ANWCC

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

Event Name and Club

Year

Type

Overall Position

Fees

Entry Fee

£

Club Membership

£

Optional Charity Donation

£

Total Money to be sent

£

Payment Method and Details

Please pay via Bacs (preferred)

Bank Details: Sort Code - 20 77 85 Account No - 03353168

or by cheque ASAP. Cheques should be made payable to Welsh Border Car Club Ltd and should be sent to

David Hillidge

14 Maes yr Eglwys

Llansantffraid

Powys

SY22 6BE

Note; If the name on Bank Transfer/Bacs is different from name entering please put crew names as Bacs reference number. Please put name of person making payment in box below

Marshal Details

Name

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

No

There will be a number of photographers throughout and during the event, if you do not wish to have your photo taken please reply to this email. If you do not reply to this email you are giving authorisation for these photographs to be taken.

Yes

No

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 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 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.."