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2019 Entries
2019 Entries
Gary Baldwin
2019-01-20T13:41:58+00:00
2019 Malcolm Wilson Rally Entry Form
Drivers Details
Sponsors
Driver
*
Age (if under 18)
Under 18's Guardian to be present on event and sign-on with competitor
Address
*
Town/City
*
Postcode
*
Home Phone
Mobile
Club
*
MSA Licence Nº
*
Email
*
Next of Kin
*
Next of Kin Mobile
*
Co-driver Details
Co-driver
*
Age (if under 18)
Under 18's Guardian to be present on event and sign-on with competitor
Address
*
Town/City
*
Postcode
*
Home Phone
Mobile
Club
*
MSA Licence Nº
*
Co-driver Email
*
note: this is the main correspondence email address
Next of Kin
*
Next of Kin Mobile
*
Vehicle Details
Car Make
*
Model
*
Reg Nº
*
Colour
*
Capacity (cc)
*
Drive
*
2 wheel drive
4 wheel drive
Class
*
Class RF1.0
Class RF1.4
Class RF1.6
Class 1400C
Class 1400S
Class N3*
Class N4*
Class B10
Class B11
Class B12
Class B13
Class B14
Class H1
Class H2
Class H3
Insurance Company Name
*
Address
Town/City
Postcode
Do you comply with SR17?
Yes
No
Postal Details for Final Instructions
FINAL INSTRUCTIONS
including Road Books, will be sent out, by first class post in the week prior to the event. If you need them delivered to someone other than the Co-driver, please fill in address below.
Name
Address
Town/City
Postcode
Seeding Information
Please list previous finishes last 2 events, these will be checked
Event 1
Date
Event & Status
Start Nº
Class Position
O/A Position
Event 2
Date
Event & Status
Start Nº
Class Position
O/A Position
Championships
please indicate which you are contesting
BTRDA® Gold Star Championship
BTRDA® Silver Star Championship
Fuchs Lubricants 1400 Championship
BTRDA Rally First Championship
BTRDA® Historic Cup
BTRDA® Production Cup
BTRDA Rallye R2 Cup
The Maxxis Tyres Motorsport UK 2019 English Rally Championship
The MRF Fiesta Trophy
The ANWCC Forest & Historic Stage Championships
The SG Petch ANECCC Stage Rally Championship
Payment Information
For Registered RALLY FIRST Competitors only £475 payable as:
£50.00 deposit and £425.00 post dated cheque
NON-RALLY FIRST ENTRIES - ENTRY FEE OF £525 MAY BE SENT AS:
£50 non-refundable deposit
Dated now
Remaining £475.00 of entry fee
Dated Now
INSURANCE PREMIUM standard £25
Management Pack £25
Please enter Total here
Cheques to be made payable to Malcolm Wilson Rally.
Payment can also be made via BACS Barclays Bank, Malcolm Wilson Rally, Sort Code 204761, Account No 30060674 Please use drivers last name as reference.
Verification
Please enter any two digits
*
Example: 12
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