Entry Form
Update Entry
Entry List

Prima Motorsport Stages ~ 3rd September 2017

Web Entry Form
Please enter the rally using this form, and then pay by cheque following the instructions on the next page.
You will appear in the entry list as a pending entry immediately, and as an accepted entry once the Entries Secretary has received your payment.
Held under the General Regulations of the Motor Sports Association (incorporating the provisions of the International Sporting Code of the FIA) and the Supplementary Regulations for this event.

Undertakings & Indemnities as required by MSA GR H32 to H39 are included on the Official Signing-On Forms for the event (GR D13.13),
also by submission of the Entry Form you agree to abide by MSA 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 MSA GR D12.3.8 and D13.1.1(c).
Please contact the Entries Secretary Cat Webb with any questions regarding an entry.
07872 928622 or cat.entrysec@yahoo.com
Password
To allow you to update your entry details later.
Entrant If not crew.
Name
Entrant Licence Number
Driver
Name
Address
Town
County
Postcode
Telephone (Day)
Telephone (Evening)
Mobile
Email
Club
MSA Licence Number
Championships ASWMC Subaru Spares Sealed Surface Championship  
ACSMC Hamilton Classics Tarmacadam Stage Rally Championship  
Championship Registration Numbers
Age (if under 18)
Parent/Guardian
Parent or guardian details if under 18.
Next of Kin
Name, relationship, address & telephone number of a person to be contacted in case of a serious accident.
Co-driver
Name
Address
Town
County
Postcode
Telephone (Day)
Telephone (Evening)
Mobile
Email
Club
MSA Licence Number
Championships ASWMC Subaru WRC Spares Sealed Surface Championship  
ACSMC Hamilton Classics Tarmacadam Stage Rally Championship  
Championship Registration Numbers
Age (if under 18)
Parent/Guardian
Parent or guardian details if under 18.
Next of Kin
Name, relationship, address & telephone number of a person to be contacted in case of a serious accident.
Car
Make
Model
Engine Capacity
Colour
Registration
Class Class A - Up to 1400cc
Class B - 1401cc to 1600cc
Class C - 1601cc to 2000cc
Class D - Over 2000cc
Class E - All 4 Wheel Drive

TBA 
Forced Induction No   Yes
Four Wheel Drive? No   Yes
Award Eligibility Front Wheel Drive   Rear Wheel Drive   BDCC Crew  
Correspondence to Both by Email   Driver   Co-driver 
Seeding Category Please pick the appropriate seeding category for yourself:
1 Last year's winner
2 Driver has won an event
3 Driver has finished 2nd - 5th
4 Driver has finished 6th - 10th
5 Driver has finished 11th - 15th
6 Driver has finished 16th - 20th
7 Driver has finished 21st - 30th
8 Driver has finished 31st - 40th
9 Driver has finished 41st - 50th
10 Driver has finished 51st - 60th
11 Any Other
Seeding Information Any other relevant seeding information:
Entry Fee Entry Fee - £195   BDCC Discounted Entry Fee - £185.25   for both Crew Members belonging to BDCC on or before 15/1/2017
Bournemouth & District CC Membership Not Needed   Driver - £20.50   Co-driver - £20.50   Both - £41  
Payment Method Entry fees can be paid via Cheque, Debit Card (Switch etc), Credit Card (Mastercard or Visa) or BACS.
Payment by credit card will NOT be subject to a handling charge.

If paying by BACS, the Entries Secretary will forward bank account details after the entry is made.
If paying by Card the Entries Secretary will contact you for credit/debit card details.

Cheque   Credit/Debit Card   BACS  

Entry System available from Tony Michael