Isle of Man Historic Rally 2010 Internet Entry Form

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

Entries Close for seeding on Friday 18th June at 5pm

Entries Secretary: Kate Barrs
Rally Isle of Man
Memorial Hall
Union Mills
Isle of Man
IM4 4AD

Telephone: +44 (0) 1624 852440

E-Mail: entries@rallyisleofman.co.im

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

Welcome to the Isle of Man Historic Rally 2010 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 two 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 Barclays
      Sort Code 20-26-74
      Account No. 40898279
      Account Name Rally Isle of Man
      Reference Driver's full name.
    2. You can send a cheque, made payable to 'Rally Isle of Man' to the Entries Secretary at the address above. Please include drivers name on back of Cheque
  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@rallyisleofman.co.im 
Document Addressing
E-Mail address for communication
Real Name of this person
Driver
Full Name
Address
Post Code
Telephone Number
Mobile Number
Competition Licence Number
Competition Licence Issuer
E-Mail Address

Town for Entry List

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

Town for Entry List

Car Details
Make
Model
Colour
Registration Number
Engine Capacity
Class
Insurance

If you require cover under the Richard Egger Motor Sports Road Traffic Scheme, payment may be made with your entry or at Admin Checks.

If you are arranging your own Road Traffic cover, please provide details below.
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 Historic Rally Championship incorporating the HRCR Cup
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
Recce Dates and Shakedown

Please only select Yes for one Recce options
Saturday July 3rd and Sunday July 4th
Wednesday July 7th and Thursday July 8th
Are you planning to participate in Shakedown?

Fees - see above for how to pay

Entry Fee £
Insurance£
Shakedown£
Auxiliary Plate £
Motorhome Plate£
Guest Pack£
We Support “The Marshals” stickers @ £5.00 each£
Total Money to be sent £
Payment Method and Details
Entrant (if applicable and not driver)
Name
Address
Post Code
Telephone Number
Competition Licence Number
Competition Licence Issuer
Comments
Anything else you'd like to tell us

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.

Declaration of Indemnity

 

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.

2. 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 the roads defined by the law.

3. I understand that should I at the 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 such
disability to the ASN who have, following such declaration, issued a licence which permits me to do so.

4. Any application form for a licence which was signed by a person under the age of 18 years was countersigned by
that person’s parent/guardian/guarantor, whose names and addresses have 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. As the Parent/Guarantor “I can 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 to the maxima set out in MSA General Regulations Part 3, Appendix 1”

Note: Where the parent/guardian/guarantor of the driver 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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