Password To allow you to update your entry details, and to access the online signing-on form later. Keep a note of this.
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
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
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
Forced Induction?
No
Yes
Class TBA E SE N E - Experts: Either crew member having finished in the top 5 of a similar or higher status event.
SE - Semi-Experts: Those crews not eligible for classes E or N.
N - Novices: Neither crew member having won an award other than a team, marque or finisher’s award, on an event of National B or higher status.
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 90?
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 - £32
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.
Entry Entry - £235 (up to 7th December 2024 12:00)
Payment Method
Bank Payment 
Payment details will be displayed after the entry is submitted
Chelmsford Motor 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.
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.