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Name
Address
Address
Address
Town
County
Postcode
Telephone (Day)
Telephone (Evening)
Mobile
Email It is important that this is correct.
Club
Nationality
Choose... British English Welsh Scottish Irish Manx Afghani American Andorian Angolian Anguillan Antarctic Argentine Armenian Arubian Australian Austrian Bahameese Bahrainian Bangladeshi Barbadian Belarusian Belgian Belizean Bermuda Bhutanese Bolivian Brazilian British Bulgarian Cambodian Cameroonian Canadian Chilean Chinese Chinese Columbian Congolese Costa Rican Croatian Cuban Cypriot Czech Danish Dominican Dutch Ecuadorean Egyptian Emirian Estonian Ethiopian Fijian Filipino Finnish French Georgian German Ghanaian Greek Guinean Guyanese Hungarian Icelander Indian Indonesian Iranian Iraqi Irish Israeli Italian Jamaican Japanese Jordanian Kazakhstani Kenyan Korean Kuwaiti Lebanese Lithunian Luxembourger Macau Malaysian Maldivan Mauritian Mayanmarese Mexican Monacan Mongolian Moroccan Namibian Nepalese New Zealander Nigerian Norwegian Omani Pakistani Panamanian Paraguayan Peruvian Polish Portugees Qatari Romanian Russian Saudi Arabian Senegalese Seychellois Singaporean Slovakian Somali South African Spanish Sri Lankan Swedish Swiss Taiwanese Tanzanian Thai Tunisian Turkish Ugandan Ukrainian Uruguayan Uzbekistani Venezuelan Vietnamese Yemeni Zambian Zimbabwean Latvian Competition Licence Number
Championships H H - HRCR Clubmans Road Rally Championship
Age
Choose... 17 18 19+ Name
Relationship
Address
Mobile
At Event?
No
Yes
Name
Relationship
Address Including Postcode
Mobile
At Event?
No
Yes
Name
Address
Address
Address
Town
County
Postcode
Telephone (Day)
Telephone (Evening)
Mobile
Email It is important that this is correct.
Club
Nationality
Choose... British English Welsh Scottish Irish Manx Afghani American Andorian Angolian Anguillan Antarctic Argentine Armenian Arubian Australian Austrian Bahameese Bahrainian Bangladeshi Barbadian Belarusian Belgian Belizean Bermuda Bhutanese Bolivian Brazilian British Bulgarian Cambodian Cameroonian Canadian Chilean Chinese Chinese Columbian Congolese Costa Rican Croatian Cuban Cypriot Czech Danish Dominican Dutch Ecuadorean Egyptian Emirian Estonian Ethiopian Fijian Filipino Finnish French Georgian German Ghanaian Greek Guinean Guyanese Hungarian Icelander Indian Indonesian Iranian Iraqi Irish Israeli Italian Jamaican Japanese Jordanian Kazakhstani Kenyan Korean Kuwaiti Lebanese Lithunian Luxembourger Macau Malaysian Maldivan Mauritian Mayanmarese Mexican Monacan Mongolian Moroccan Namibian Nepalese New Zealander Nigerian Norwegian Omani Pakistani Panamanian Paraguayan Peruvian Polish Portugees Qatari Romanian Russian Saudi Arabian Senegalese Seychellois Singaporean Slovakian Somali South African Spanish Sri Lankan Swedish Swiss Taiwanese Tanzanian Thai Tunisian Turkish Ugandan Ukrainian Uruguayan Uzbekistani Venezuelan Vietnamese Yemeni Zambian Zimbabwean Latvian Competition Licence Number
Championships H H - HRCR Clubmans Road Rally Championship
Age
Choose... 12 13 14 15 16 17 18-24 25+ Name
Relationship
Address
Mobile
At Event?
No
Yes
Name
Relationship
Address Including Postcode
Mobile
At Event?
No
Yes
Make
Model
Registration
CC
Colour
Year
Waiver Needed for?
Cylinders > 4.
Carburetter chokes > 2.
More than 1 camshaft per bank.
Category1, Category 2, Category 3, Category 4a or Category 4b cars that do not fully comply with NCR Ch. 13 App. 15 Art. 3.1-3.4 may be considered for acceptance subject to the organisers being granted specific waivers by Motorsport UK in accordance with Ch. 13 App. 15 Art. 11.3.
Make & Model of Tripmeter fitted to car.
Class TBA M1 M2 M3 M4 M5 E1 E2 E3 E4 E5 N1 N2 N3 N4 N5 C1 C2 M1: Masters in Pre-68 Category 1 cars
M2: Masters in 1968-74 Category 2 cars
M3: Masters in 1975-81 Category 3 cars
M4: Masters in 1982-85 Category 4A cars
M5: Masters in 1986-90 Category 4B cars
E1: Experts in Pre-68 Category 1 cars
E2: Experts in 1968-74 Category 2 cars
E3: Experts in 1975-81 Category 3 cars
E4: Experts in 1982-85 Category 4A cars
E5: Experts in 1986-90 Category 4B cars
N1: Novices in Pre-68 Category 1 cars
N2: Novices in 1968-74 Category 2 cars
N3: Novices in 1975-81 Category 3 cars
N4: Novices in 1982-85 Category 4A cars
N5: Novices in 1986-90 Category 4B cars
Clubman’s classes
C1: Clubmen in Pre-82 Categories 1-3 cars
C2: Clubmen in 1982-92 Categories 4A & 4B cars
Master - a crew where any member has had 4 or more finishes in the top 10 places
overall of an Interclub, National B or higher status historic road rally in the last 5 years.
Expert - a crew which does not qualify for Master or Novice.
Novice - a crew in which no member has had 4 or more finishes in the top 25 places
overall of an Interclub, National B or higher status historic road rally in the last 5 years.
The above apply to driver’s results as a driver and navigator’s results as a navigator.
Driver Meal TBA No Meal Chilli Con Carne Lasagna Vegetarian option Saturday evening meal
Navigator Meal TBA No Meal Chilli Con Carne Lasagna Vegetarian option Saturday evening meal
Seeding Information Please detail the most recent relevant results.
Event Year Status Overall Position Class Position.
Seeding Position Where would you expect to be seeded out of 60?
Distance to travel to the event Miles one way. If multiple vehicles are travelling for your entry, add up the total.
Special Dietary Requirements Give name and requirements.
Insurance
Own Insurance
REIS - £34
Insurance Declaration
I am aged 19 or over
I have held a full UK / EU Driving Licence for a minimum of 6 months
I have no more than 6 points on my licence and no bans of any kind
I have had no more than 1 fault claim in the last 3 years
I do not have the Third-Party Extension cover on my existing motor policy
My vehicle has a valid MOT & is taxed for the road, unless exempt from doing so
I am named on a valid motor insurance policy for the vehicle I am driving
Anyone aged less than 19 years old will also be accepted at the same price should their co-driver be a more senior member of their family or over 25. Any competitor who falls outside these parameters may be offered cover at equivalent terms or an agreed price, if approval from the Appointed Insurance Broker has been obtained by the event organisers, prior to the event.
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.
Entry Entry - £275 (up to 9th March 2025 23:59)
Payment Method
Bank Payment 
Payment details will be displayed after the entry is submitted
Salisbury & Shaftesbury Car Club 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.
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