Entry Form

Entry Form
Update Entry
Entry List

Signing-on will be available here
from 25th November 2024 9:00
to 10th January 2025 20:00
Competitor Signing-On

Marshal/Official Signing-on will be available here
from 25th November 2024 9:00
to 10th January 2025 20:00
Official/Marshal Signing-On

January Jaunt 12 Car ~ 10th January 2025

Entry Form

Please enter the event using this form, and then pay following the instructions on the next page.

You will appear in the entry list as an accepted entry once the Entries Secretary has received your payment and verified your entry is complete.

Held under the General Regulations of Motorsport UK (incorporating the provisions of the International Sporting Code of the FIA), these Supplementary Regulations and any written instructions (including bulletins) that the organising club may issue for the event.

Undertakings & Indemnities as required by Motorsport UK GR D13.1 to D13.1.5 are included on the Official Signing-On Forms for the event, also by submission of the Entry Form you agree to abide by Motorsport UK Regulations and any written instructions issued for the event.

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 Motorsport UK D13.1.1(c).

Entries will not be considered for acceptance until full payment has been received and the entry form is complete.

Password To allow you to update your entry details, and to access the online signing-on form later. Keep a note of this.
Driver
Name
Address
Address
Address
Town
County
Postcode
Telephone (Day)
Telephone (Evening)
Mobile
Email It is important that this is correct.
Club
Competition Licence Number
Age
Driver's Parent or Guardian (under 18 only)
Name
Relationship
Address
Mobile
At Event? No Yes
Persons to contact in case of serious accident to Driver
Name
Relationship
Address Including Postcode
Mobile
At Event? No Yes
Navigator
Name
Address
Address
Address
Town
County
Postcode
Telephone (Day)
Telephone (Evening)
Mobile
Email It is important that this is correct.
Club
Competition Licence Number
Age
Navigator's Parent or Guardian (under 18 only)
Name
Relationship
Address
Mobile
At Event? No Yes
Persons to contact in case of serious accident to Navigator
Name
Relationship
Address Including Postcode
Mobile
At Event? No Yes
Vehicle
Make
Model
Registration
CC
Colour
Year
Forced Induction? No Yes
Class TBA M E N B Master - Has come in the top five of a National ‘B’ status road rally or Navigational rally as a navigator in the past 10 years. If over 10 years you may enter as Expert. Expert - Has won three or more First Overall awards on any 12 car or 20/20 events as a navigator. Or has been First Novice five or more times on any 12 car or 20/20 events as a navigator since 1st September 2016. Novice - All others. Beginner - Has not competed in more than five rallies as a navigator.
Carbon Footprint
Distance to travel to the event Miles one way. If multiple vehicles are travelling for your entry, add up the total.

Insurance
Insurance Own Insurance REIS - £22
Insurance Declaration I am aged 19 or over I have held a full UK Driving Licence for a minimum of 6 months I have no more than 6 points on my licence I have had no more than 1 fault claim in the last 3 years I am named on a valid motor insurance policy for the vehicle I am driving I do not have the Third-Party Extension cover on my existing motor policy My vehicle has a valid MOT Certificate & is taxed for the road, unless exempt from doing so Please note, this is a “Top up” Insurance policy that will essentially attach on top of your standard road insurance. You MUST have a standard policy as well as taking out this insurance otherwise it will be null and void.
If using the event REIS insurance, do you comply with the Declaration? No Yes Own Insurance If you choose No, you will be sent a Declaration Form to complete.
Insurance company name, address and telephone number
Policy No.
Fees
Entry Entry - £15 (up to 3rd January 2025 18:00)
Payment Method Bank Payment Payment details will be displayed after the entry is submitted

Anglia Motor Sport Club / Chelmsford MC complies with current data protection legislation. I agree that the information submitted through this form, including names, addresses and contact details, may be published or released to other parties purely for purposes connected with the event.
If a required field is not filled in, the form will scroll to that field so you can complete it before trying to submit the entry again.

Entry System via MTC1.uk