Pendragon Stages 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

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 You cannot sign on until this is filled in

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

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

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

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

Competition Licence Issuer

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

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

Competition Licence Issuer

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

Year

Forced Induction

No

Yes

Four Wheel Drive

No

Yes

Class You cannot sign on until this is filled in

A - NCR Class 1 Homologated FIA Rally 2 and R5 cars and derivatives. FIA S2000 specification cars and derivatives. All World Rally cars (must comply with homologation). NCR Class 2 All 4-wheel drive cars over 2000cc. NCR Class 4 Homologated FIA Rally 3 cars and Group N4 that comply with homologation

B - NCR Class 3 2-wheel drive cars with normally aspirated engines over 2000cc or forced induction engines over 1500cc. Homologated (and formerly homologated) FIA RGT cars

C - NCR Class 5 Homologated FIA Rally 4 and R2 cars with forced induction that still comply with their homologation. NCR Class 6 Cars with normally aspirated engines over 1600cc up to and including 2000cc or forced induction engines up to and including 1500cc

D - NCR Class 7 Homologated FIA Rally 5 and Rally 5-Kit cars NCR Class 8 Cars with normally aspirated engines over 1400cc up to and including 1600cc, including R2, or forced induction engines up to and including 1000cc

E - NCR Class 9 Cars with normally aspirated engines up to and including 1400cc

In Car Camera Request

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

Service Vehicle

Make

Model

Colour

Registration Number

Contact Name

Contact Number

Championships

AS Performance North of England Rally Championship

Crew Members Registered

None

Driver

Co-Driver

Both

Driver Championship Registration Number

Co-Driver Championship Registration Number

Carnegie Fuels Scottish Tarmack Rally Championship

Crew Members Registered

None

Driver

Co-Driver

Both

Driver Championship Registration Number

Co-Driver Championship Registration Number

The Mini Rally Challenge

Crew Members Registered

None

Driver

Co-Driver

Both

Driver Championship Registration Number

Co-Driver Championship Registration Number

HRCR Mini and Cat 1 Rally Championship

Crew Members Registered

None

Driver

Co-Driver

Both

Driver Championship Registration Number

Co-Driver Championship Registration Number

SD34MSG Stage Rally Championship

Crew Members Registered

None

Driver

Co-Driver

Both

Driver Championship Registration Number

Co-Driver Championship Registration Number

ANWCC Stage Rally Championship

Crew Members Registered

None

Driver

Co-Driver

Both

Driver Championship Registration Number

Co-Driver Championship Registration Number

KLMC Stage Challenge

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 90 entries, where do you think you should be seeded?

Scrutineering

When would you prefer to scrutineer?

Saturday

Fees - see above for how to pay

Entry Fee

£

Insurance

£

Extra Donation to the Marshals Fund

£

Total Money to be sent

£

Payment Method and Details This must be filled in to continue

Entrant (if applicable and not driver)

Name

Address

Post Code

Telephone Number

Nationality

Competition Licence Number

Competition Licence Issuer

Club Membership No

Marshal Details

Name

Address

Post Code

Telephone Number

Mobile Number

Email Address

Experience

Comments

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 [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

No

Remember your entry is subject to receipt of the correct entry fee. An automated acknowledgement is NOT confirmation of entry. Rejected entries and entries held in abeyance will be informed by e-mail to the address(es) given above.

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 NCRs of the Motor Sports Association 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.."

Bank	Barclays
Sort Code	20-66-97
Account No.	80822647
Account Name	pendragon stages
Reference	Driver's full name.