Pirelli International Rally 2009 Internet Entry Form

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

Entries Close for seeding on 3rd April 2009 at 10am

Entries Secretary: Chris Walker

7 Moorhouse Road
Carlisle
CA2 7LU

Telephone: 01228 533157  before 9pm only

E-Mail:entries@pirelliinternationalrally.co.uk

Held under the General Regulations of the Motor Sports Association (incorporating the International Sporting Code of the FIA) and the Supplementary Regulations

Welcome to Pirelli International Rally 2009 Online Entry system. Please follow the steps below to enter the rally.

  1. Complete all the fields in the form below. The fields with red backgrounds are mandatory.
  2. 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.
  3. There are then three ways to pay
    1. If you have internet or telephone banking, you can arrange for the fees to be paid directly into our account. The details are:-
      Bank HSBC
      Sort Code 40-16-22
      Account No. 61204556
      Account Name Cumberland Sporting Car Club
      Reference Driver's full name.
    2. You can send a cheque, made payable to 'Cumberland Sporting Car Club' to the Entries Secretary at the address above. Please include drivers name on back of Cheque
    3. If you would like to pay via credit or debit card, please telephone 0141 946 5045 with your card details, (there is a fee for service, which you will be informed of when giving details)
  4. Within 24 hours of us receiving the payment for your entry you should receive an e-mail confirming your entry from the Entries Secretary. NOTE: WITHOUT PAYMENT YOUR ENTRY WILL NOT BE VALID.
  5. If you don't receive a response within 3 days of the expected payment date, or if you have any other questions, please e-mail entries@pirelliinternationalrally.co.uk

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.

If you want the finals Etc: to go to other than Driver/Co-Driver please ensure that name is the one in the Document Addressing below

Document addressing

E-Mail address for communication
Real Name of this person
How would you like to receive Finals? 
(If Post please supply Address)		E-mail/WebsitePosted Paper

Driver

Full Name
Address
Post Code
Telephone Number
Mobile Phone Number
Competition Licence Number
E-Mail Address  
Co-Driver
Full Name
Address
Post Code
Telephone Number
Mobile Phone Number
Competition Licence Number
E-Mail Address  

Car

Make
Model
Colour
Registration Number
Engine Capacity
Forced InductionNo
Yes
Four Wheel DriveNo
Yes
ClassR4 - Rally 4
R3 - Rally 3
R2 - Rally 2
R1 - Rally 1
FIA Homologation Number
Insurers
Name
Address

Sponsor

Sponsor Name
Note: This sponsor does not need an entrant's licence. If you have an entrant with an entrant's licence, please give details later.

Championships

MSA British Rally ChampionshipNo
Driver Only
Co-Driver Only
Both Crew Members
Citroen C2 R2 CupNo
Driver Only
Co-Driver Only
Both Crew Members
Fiesta Sporting TrophyNo
Driver Only
Co-Driver Only
Both Crew Members
Suzuki Swift CupNo
Driver Only
Co-Driver Only
Both Crew Members
Teams ChampionshipNo
Driver Only
Co-Driver Only
Both Crew Members

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 Stage Rallies by Driver Only

We can only seed you on the information you supply - please give as much detail as possible

Event Name and ClubYearTypeSurfaceOverall PositionNo of Starters

Scrutineering

Please indicate your preferred Scrutineering Times. Note that preference is given to early entries. Although we will try to accomodate all rerquests this cannot be guaranteed.

Friday 13:00
Friday 13:15
Friday 13:30
Friday 13:45
Friday 14:00
Friday 14:15
Friday 14:30
Friday 14:45
Participating in Recce? Yes
No
Participating in Shakedown? Yes
No

Fees - see above for how to pay

Entry Fee £
Insurance£
Shakedown Fee£
Additional Auxiliary Plate £
Motorhome Plate£
Support Plate£
Guest Pack£
Marshals' Hospitality Bag Fund£
Total Money to be sent £
Payment Method and details

Entrant (if applicable and not driver)

Full Name
Address
Post Code
Telephone Number
Entrants Licence Number

Service Area Requirments 
Within each individual event only. 

The details on this form will be held on computer in order to be used for the administration of this event. They will also be used to send you information about future events organised by this club, unless you untick this box to indicate you do not wish to receive information on further events.
The details on this form may also be passed on to other motorsport organisations, unless you untick this box to indicate you do not wish these details passed on.

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 declare that:
1 I have been given an opportunity to read the General Regulations 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.
2 The use of the vehicle hereby entered is covered by insurance as required by the law which is valid for such part of this event as shall take place on roads as defined by the law.
3 I understand that should I at any time of this event be suffering from any disability whether permanent or temporary which is likely to affect prejudicially my normal control of the vehicle, I may not take part unless I have declared any such disability to the ASN which has, following such a declaration, issued a licence which permits me to do so.
4 Any application form for a licence which was signed by a person under 18 years of age was countersigned by that person’s parent/guardian/guarantor, whose full name and address has been given.
5 If I am the parent/guardian/guarantor of the driver, I understand that I shall have the right to be present during any procedure being carried out under the Supplementary Regulations issued for this event and the General Regulations of the MSA.
6 As the Parent/ Guardian/Guarantor, I confirm that I have acquainted myself with the MSA General Regulations, agree
to pay any appropriate charges and fees pursuant to those Regulations (to include any appendices thereto) and hereby agree to be bound by those regulations and submit myself without reserve to the consequences resulting from those regulations (and any subsequent alteration thereof). Further, I agree to pay as liquidated damages any fines imposed upon me up the maxima set out in Part 3, Appendix 3 of the 2009 MSA Yearbook.
Note: Where the parent/guardian/guarantor is not present there must be a representative who must produce a written and signed authorisation to so act from the parent/guardian/guarantor as appropriate.

 

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