Stopastride Live | Derek Walker Memorial Classic Trial Entry Form

Derek Walker Memorial Classic Trial Entry Form

Event Details:
MGCC Ulster Centre
15th February 2025
Ballynabragget, Donaghacloney BT66 7PN

Entries Secretary:
Simon Johnston
07711636554
[email protected]

This event is held under the General Regulations of Motorsport UK (incorporating the provisions of the International Sporting Code of the FIA) and these Supplementary Regulations.

Driver

Forename*

Surname*

Address*

Town/City*

Postcode*

Email*

Telephone*

Club*

Competition Licence Number*

Issuing Association*

eg. Motorport UK/Ireland

Licence Type*

eg. RS Clubman

Next of Kin:

Name*

Relationship*

Telephone*

Driver over age of 18*

Yes

Date of Birth*

Driver's Parent/Guardian/Guarantor:

Name*

Telephone*

Address*

Full address including postcode, or 'as above' if same as driver's address.

Car

Make*

Model*

Cubic Capacity*

Registration Number*

Class*

Class 1 - Pre1955 MGs and UVCC eligible vehicles

Class 2 - Post 1955 sports cars in production to end 1980

Class 3 - Midgets and Sprites without LSD and with original type engine

Class 4 - Midgets and Sprites with LSD and with original type engine

Class 5 - Non original type engine MGs

Class 6 - Front engine FWD rear engine RWD cars in production prior to end 1980

Class 7 - Front engine RWD cars in production prior to end 1980

Class 8 - MG marque only manufactured after 1 January 1981

Class 9 - All other cars manufactured after 1 January 1981

Production Car Navigator

Forename*

Surname*

Date of Birth*

Address*

Town/City*

Postcode*

Email*

Telephone*

Club

Competition Licence Number

Issuing Association

eg. Motorport UK

Licence Type

eg. RS Clubman

Next of Kin:

Name*

Relationship*

Telephone*

Navigator over age of 18*

Yes

Navigator's Parent/Guardian/Guarantor:

Name*

Telephone*

Address*

Full address including postcode, or 'as above' if same as driver's address.

Full name of other driver*

All drivers must submit a separate entry form

Entry Fee's

	Cost	Select
MG Car Club members	£85
Non-members of MGCC	£95
Reis road insurance	£27

Total: £0

Payment Method*

Credit/Debit Card

I have read, understand and accept MGCC Ulster Centre's privacy policy and Stopastride Live Timing's privacy policy. *