Entry Form - Cars

Entry Form - Cars

This entry form is for cars only. There is a different form for bikes, combinations and 3 wheelers.
This section of the form is for details of the driver
Name *

First Name Last Name
Email *
Address *

Street Address

Street Address Line 2

Town/City County

Postcode
Phone number *
Club *
If you are not a member of an invited club then you can join Fell Side Auto Club for £15 as part of your entry
Motorsport UK License Number *
If TBA you must inform us at least 10 days before the event. Licenses must be available for inspection at the start. If Under 18, please type "U18".
ACTC Championship Number (optional)

Emergency Contact for Driver

This is a relative or friend that we should contact in the event of a serious accident.
Name *

First Name Last Name
Address *

Street Address

Street Address Line 2

Town/City County

Postcode
Phone number *
Their relation to the driver *

How many passengers will you have (this will decide the number of passenger information sets you will complete)? *

1 2 3 4

This section of the form is for details of a passenger
Name *

First Name Last Name
Email *
Address *

Street Address

Street Address Line 2

Town/City County

Postcode
Phone number *
Club *
As of 2020, Motorsport UK requires that all passengers must also be members of an invited club. As part of your entry, you can buy your passenger a full membership of Fell Side Auto Club for £15 or a Northern Trial Passenger membership of Fell Side Auto Club for £1.
Motorsport UK License Number *
If TBA you must inform us at least 10 days before the event. Licenses must be available for inspection at the start. If under 18, please type "U18".
Is the passenger aged 18 or under? *

Yes - You must complete a parent/guardian consent form, available from our website under "Forms" No
ACTC Championship Number (optional)
Emergency Contact for Passenger

This is a relative or friend that we should contact in the event of a serious accident.
Name *

First Name Last Name
Address *

Street Address

Street Address Line 2

Town/City County

Postcode
Phone number *
Their relation to the passenger *

This section of the form is for details of a passenger
Name *

First Name Last Name
Email *
Address *

Street Address

Street Address Line 2

Town/City County

Postcode
Phone number *
Club *
As of 2020, Motorsport UK requires that all passengers must also be members of an invited club. As part of your entry, you can buy your passenger a full membership of Fell Side Auto Club for £15 or a Northern Trial Passenger membership of Fell Side Auto Club for £1.
Motorsport UK License Number *
If TBA you must inform us at least 10 days before the event. Licenses must be available for inspection at the start. If under 18, please type "U18".
Is the passenger aged 18 or under? *

Yes - You must complete a parent/guardian consent form, available from our website under "Forms" No
ACTC Championship Number (optional)
Emergency Contact for Passenger

This is a relative or friend that we should contact in the event of a serious accident.
Name *

First Name Last Name
Address *

Street Address

Street Address Line 2

Town/City County

Postcode
Phone number *
Their relation to the passenger *

This section of the form is for details of a passenger
Name *

First Name Last Name
Email *
Address *

Street Address

Street Address Line 2

Town/City County

Postcode
Phone number *
Club *
As of 2020, Motorsport UK requires that all passengers must also be members of an invited club. As part of your entry, you can buy your passenger a full membership of Fell Side Auto Club for £15 or a Northern Trial Passenger membership of Fell Side Auto Club for £1.
Motorsport UK License Number *
If TBA you must inform us at least 10 days before the event. Licenses must be available for inspection at the start. If under 18, please type "U18".
Is the passenger aged 18 or under? *

Yes - You must complete a parent/guardian consent form, available from our website under "Forms" No
ACTC Championship Number (optional)
Emergency Contact for Passenger

This is a relative or friend that we should contact in the event of a serious accident.
Name *

First Name Last Name
Address *

Street Address

Street Address Line 2

Town/City County

Postcode
Phone number *
Their relation to the passenger *

This section of the form is for details of a passenger
Name *

First Name Last Name
Email *
Address *

Street Address

Street Address Line 2

Town/City County

Postcode
Phone number *
Club *
As of 2020, Motorsport UK requires that all passengers must also be members of an invited club. As part of your entry, you can buy your passenger a full membership of Fell Side Auto Club for £15 or a Northern Trial Passenger membership of Fell Side Auto Club for £1.
Motorsport UK License Number *
If TBA you must inform us at least 10 days before the event. Licenses must be available for inspection at the start. If under 18, please type "U18".
Is the passenger aged 18 or under? *

Yes - You must complete a parent/guardian consent form, available from our website under "Forms" No
ACTC Championship Number (optional)
Emergency Contact for Passenger

This is a relative or friend that we should contact in the event of a serious accident.
Name *

First Name Last Name
Address *

Street Address

Street Address Line 2

Town/City County

Postcode
Phone number *
Their relation to the passenger *

This section of the form is for details of the vehicle
Make of car *
Model *
Class *
Registration number *
Engine capacity (cc) *
Year of registration *
Is your vehicle fitted with a limited slip differential or other traction control device? *

No Other
Front Tyres
Make *
Size *
Type *
Rear Tyres
Make *
Size *
Type *

This section is for pre-ordering meals at the finish venue

Pre-ordering is essential
Will you eat at the New Stocksman after the trial? *

Yes No

Meals

Mains: £9.50, Desserts: £4, mains include tea or coffee.
Roast Beef
Steak Pie
Fish & Chips
Cumberland Sausage
Vegetarian Option
Trifle
Apple Crumble & Custard
Rice Pudding
Total cost of meals

Declaration of Indemnity
I have read the supplementary regulations issued for this event & agree to be bound by them and by the General Regulations of Motorsport UK (for cars) and the Standing Regulations of the ACU (for motorcycles, combinations and three-wheelers). I declare that I am physically and mentally fit to take part in the event and I am competent to do so. I acknowledge that I understand the nature and type of competition and the potential risk inherent with motorsport and agree to accept that risk. Further I understand that all persons having connection with the promotion and /or organisation and/or conduct of the event are insured against loss or injury caused through their negligence.

I declare that the use of the vehicle hereby entered will be covered by insurance as required by the law which is valid for such part of this event as shall take part on the roads and defined by the law.

Under the provision of the Data Protection Act 2018, Fell Side Auto Club requires your permission to hold the information on this entry form on a computer for the purpose of producing address lists, results and other such data for running the trial. By signing below this gives the organisers the right to enter and store this information on a computer, it will not be shared with any third party except for the purposes of organising this event.
Driver's Signature *

Please draw your signature in the box using your mouse. Signatures from passengers will be obtained at a later date. Clear

Fees

Select the relevant options and the form will calculate your total entry fee
Entry Fee

£55 before the 19th of January
RTA Insurance from REIS
To be automatically eligible for REIS insurance, the following criteria must be met:
- Age 19 years or over
- Has held a full licence for a minimum of 6 months
- Has no more than 6 points on their licence
- Has had no more than 1 fault claim in the last 3 years
- The vehicle must hold a valid MOT Cert, current road insurance, and Road Tax, unless exempt from doing so.
Do you require RTA Insurance from REIS for £16? *

Yes No
Fell Side Memberships - £15 each
Northern Trial Passenger Memberships - £1 each
Meals
Total Cost of Entry (Please make a note of this)
How will you pay this? *

BACS Cheque

Any other comments or information we should know?
Should be Empty:

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Entry Form - Cars

This section of the form is for details of the driver

Emergency Contact for Driver

This section of the form is for details of a passenger

Emergency Contact for Passenger

This section of the form is for details of a passenger

Emergency Contact for Passenger

This section of the form is for details of a passenger

Emergency Contact for Passenger

This section of the form is for details of a passenger

Emergency Contact for Passenger

This section of the form is for details of the vehicle

Front Tyres

Rear Tyres

This section is for pre-ordering meals at the finish venue

Meals

Declaration of Indemnity

Fees

Entry Fee

RTA Insurance from REIS