For office use only
Entry Application Form
Please complete ALL sections. Please use BLOCK CAPITALS and print clearly.
Usual first name
Email address * IMPORTANT - PLEASE PRINT
(please note: communication will mainly be by email)
Next of kin:
Relation to participant, name, address telephone/email.
Special note: Event communications will usually be via email. Please ensure that our sender email address firstname.lastname@example.org is in your address book. If you do not have email please enter above the email address of a relative or friend through whom we can reach you. *
Insurance (see Regulation 27); please tick ONE of the following): Either:
I will be covered by my own insurance policy valid for the event, as follows :
Name of company: or I qualify for and wish to use the scheme outlined in Regulation 27. Please read regulation 7 then tick the applicable box. ENTRY NOT VALID UNLESS COMPLETED
Category A - Heritage: May be entered in cars of a make and model first introduced before Ist January 1955.
Categories B, C and D - Classic: May be entered in cars of a make and model first introduced after 31st December 1951.
Category B - Classic - Expert: The navigator has finished twice in the top 5 overall in this or a rally of equal or higher status during the years 2014-2018. Category C - Classic - Intermediate: The navigator is not eligible for any other class. Category D - Classic - Novice: The navigator has not won an award on this or a rally of equal or higher status during the years 2014-2018.
Note: If both crew members drive each is also considered a navigator. Organisers reserve the right to reclassify. If in doubt tick higher category.
INDEMNITY: I declare that I have been given the opportunity to read the General Regulations of the Motor Sports Association and the Supplementary Regulations published for this event and I 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 the type of the competition and 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. I declare that the use of the vehicle hereby entered will be 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.
Age (see above)
Signature of parent or guardian (if aged 17 or under)
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