Duke Stages 2009 Internet Entry Form

Entries to this event are now closed and this page is for record only

Entries Close for seeding on 13th September at 7pm

Entries Secretary: Rob Fagg
Dhoon Beg
Main Road
Kirk Michael
Isle of Man

Telephone: 07624 480101
E-Mail: entries@druidalemc.org.im

Held under the General Regulations of the Motor Sports Association (incorporating the International Sporting Code of the FIA) and the Supplementary Regulations

Welcome to the Duke Stages 2009 Online Entry system. Please follow the steps below to enter the rally.

  1. Complete all the fields in the form below. The fields with red backgrounds are mandatory.
  2. Once you have hit the "Enter the Rally" button at the end you will receive an automated response confirming we have received your entry form.
  3. There are then two ways to pay
    1. If you have internet or telephone banking, you can arrange for the fees to be paid directly into our account. The details are:-
      Bank Isle of Man Bank
      Sort Code 55-91-00
      Account No. 10914315
      Account Name Druidale Motor Club Ltd
      Reference Driver's full name.
    2. You can send a cheque, made payable to 'Druidale Motor Club' to the Entries Secretary at the address above. Please include drivers name on back of Cheque
  4. Within 24 hours of us receiving the payment for your entry you should receive an e-mail confirming your entry from the Entries Secretary. NOTE: WITHOUT PAYMENT YOUR ENTRY WILL NOT BE CLASSED AS ACCEPTED.
  5. Competitors are asked to enter the details of their nominated marshal in the comments field at the bottom of the form.
  6. If you don't receive a response within 3 days of the expected payment date, or if you have any other questions, please e-mail entries@druidalemc.org.im 
Document Addressing
E-Mail address for communication
Real Name of this person
Whom should we send Finals and Results to? DriverCo-Driver
How would you like to receive Finals and Results?E-mail/WebsitePosted Paper
Driver
Full Name
Address
Post Code
Telephone Number
Mobile Phone Number
Competition Licence Number
DMC Membership No.
E-Mail Address
Co-Driver
Full Name
Address
Post Code
Telephone Number
Mobile Phone Number
Competition Licence Number
DMC Membership No.
E-Mail Address
Car
Make
Model
Colour
Registration Number
Engine Capacity
Forced InductionNo
Yes
Four Wheel DriveNo
Yes
ClassClass A - Up to and including 1400cc
Class B - 1401cc up to and including 1600cc
Class C - 1601cc up to and including to 2500cc - Front Wheel Drive
Class D - 1601cc up to and including to 2500cc - Rear Wheel Drive
Class E - Over 2551cc and all 4WD
In Car Camera Request
Insurers
Name
Address

Championships

ANWCC Stage Rally ChampionshipNo
Driver Only
Co-Driver Only
Both Crew Members
Eurocars Motorsport Manx Rally ChampionshipNo
Driver Only
Co-Driver Only
Both Crew Members

Person to be contacted in case of serious accident to Driver

Name
Address   
Post Code
Telephone Number
Relationship
Will this person be attending the event?

Person to be contacted in case of serious accident to Co-Driver

Name
Address  
Post Code
Telephone Number
Relationship
Will this person be attending the event?

Seeding - Past Performance on Stage Rallies by Driver Only

We can only seed you on the information you supply - please give as much detail as possible

Event Name and ClubYearTypeSurfaceOverall PositionNo of Starters
Seeding - Competitor Opinion
Out of 45 entries, where do you think you should be seeded?
Would you like your Road Book posting? Yes
No

Fees - see above for how to pay

Entry Fee £

Druidale Motor Club 2009 Membership

£
Insurance£
Total Money to be sent £
Payment Method and Details

Entrant (if applicable and not driver)

Full Name
Address
Post Code
Telephone Number
Competition Licence Number
Anything else you'd like to tell us

The details on this form will be held on computer in order to be used for the administration of this event. They will also be used to send you information about future events organised by this club, unless you untick this box to indicate you do not wish to receive information on further events.
The details on this form may also be passed on to other motorsport organisations, unless you untick this box to indicate you do not wish these details passed on.

Remember your entry is subject to receipt of the correct entry fee. An automated acknowledgement is NOT confirmation of entry. Rejected entries and entries held in abeyance will be informed by e-mail to the address(es) given above.

By clicking on the "Enter the Rally" button below you agree to the following:

I declare that:

I have read the Supplementary Regulations for this event and agree to be bound by them and by the General Regulations of the MSA. In consideration of the acceptance of this entry and of my being permitted to take part in this event, in respect of any parts of the event not held on a publicly adopted road, I agree to save harmless and keep indemnified the MSA, such Person, Persons or Body that may be authorised by the MSA to promote or organise this event and their respective Officials, Servants, Representatives and Agents together with other competitors and their respective Servants, Representatives and Agents, from and against all actions, claims, costs, expenses and demands in respect of Death or Injury to the Property of myself, my Driver(s), Passenger(s), Mechanic(s) or associated personnel, arising out of or in connection with this entry or my taking part in this event.

I declare that the use of the vehicle hereby entered is covered by Insurance as required by law, which is valid for such parts of the event as shall take place on public roads as defined in the law.

I understand that should I at the time of this event be suffering from any disability, whether permanent or temporary, which is likely to affect prejudicially my normal control of my vehicle, I may not take part unless I have declared such disability to the MSA which has, following such declaration, issued a licence which permits me to do so.

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