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Richard Burns Memorial Rally ~ 14th/15th August 2010
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Web Entry Form
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Please enter the rally using this form, and then pay by cheque following the instructions on the next page.
You will appear in the entry list as a pending entry immediately, and as an accepted entry once the Entries Secretary has received your
payment.
Held under the General Regulations of the Motor Sports Association (incorporating the provisions of the International Sporting Code of the FIA) and the Supplementary Regulations for this event.
Undertakings & Indemnities as required by MSA GR A32 to A39 are included on the Official Signing-On Forms for the event (GR A38), also by submission of the Entry Form you agree to abide by MSA Regulations and any written instructions issued for the event. Entries cannot be accepted from non-MSA licence holders.
Any competitor who is under 18 MUST declare so on this Entry Form and the relevant Parent/Guardian will then be required to conform to MSA GR A32 ( last paragraph) and A34(c).
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Password |
To allow you to update your entry details later. |
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Name |
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Entrant Licence Number |
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Name |
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Address |
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Town |
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County |
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Postcode |
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Telephone (Day) |
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Telephone (Evening) |
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Mobile |
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Email |
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Club |
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Licence Number |
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Championships |
S1000
F1000 |
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Age (also used for Media form) |
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Parent/Guardian |
Parent or guardian details if under 18. |
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Next of Kin |
Name, relationship, address & telephone number of a person to be contacted in case of a serious accident |
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Name |
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Address |
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Town |
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County |
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Postcode |
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Telephone (Day) |
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Telephone (Evening) |
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Mobile |
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Email |
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Club |
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Licence Number |
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Championships |
S1000
F1000 |
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Age (also used for Media form) |
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Parent/Guardian |
Parent or guardian details if under 18. |
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Next of Kin |
Name, relationship, address & telephone number of a person to be contacted in case of a serious accident |
| Make |
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| Model |
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| Engine Capacity |
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| Colour |
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| Registration |
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| Forced Induction |
No
Yes |
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Class |
TBA
A
B
C
D
E
F
G
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Scrutineering on |
TBA
Friday
Saturday |
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Camping? |
Not Required
Tent
Caravan
Tent + Caravan
Motorhome |
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Correspondence to |
Both by Email
Driver
Co-driver
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Seeding Information |
Please detail the most recent relevant results. This information will be checked.
EVENT - YEAR - STATUS - OVERALL POS. - CLASS POS.
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| Seeding Position |
Where do you think you should be seeded out of 120 entries? |
| Entry Fee |
New Competitor - £325
Returning Competitor - £295
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Kings Lynn & District MC Membership |
Not Needed
Driver - £15
Co-driver - £15
Both - £30
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Additional Party on the Pan Tickets |
None
1: £10
2: £20
3: £30
4: £40
5: £50 |
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Driver's occupation |
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Driver's hobbies |
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Driver married? |
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Driver no. of children? |
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Driver how long rallying? |
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Driver's notable results |
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Co-driver's occupation |
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Co-driver's hobbies |
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Co-driver married? |
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Co-driver no. of children? |
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Co-driver how long rallying? |
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Co-driver notable results? |
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Car year built? |
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Points of interest? |
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Media Information |
Insert below the 25 words you would wish to see about your entry in event media information
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Local radio station |
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Local newspapers |
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Local TV station |
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