PRELIMINARY ENTRY APPLICATION FORM

Division		Competitive Classic Reliability Trial (HRT)		Non-competitve Touring Rally (TR)
START POINT		London		San Sebastian

	1st driver	2nd driver
Surname	(Mr/Mrs/Miss/Ms - delete as applicable)	(Mr/Mrs/Miss/Ms - delete as applicable)
Usual first name
Age (if 18 or under)
Postal address
Telephone: work : home Fax/e-mail
HERO Member? (if yes give number)
Motorsport/driving experience
Next of kin: name Address/tel/fax

OTHER CREW MEMBERS:

No 3: Name _______________________________________ Age (if 18 or under) ______ HERO member? yes no*

No 4: Name _______________________________________ Age (if 18 or under) ______ HERO member? yes no*

* all crew members must be HERO members; if not already a member, the subscription of £5 per person will be deducted from your entry fee

VEHICLE: Make _____________________________________ Model and variant ___________________________

Body type: saloon drophead/tourer open sports GT/closed coupé No of seats _____________

Year of manufacture _______ Date of first registration ___________________ Launch year of this variant _________

Engine size __________ cc Class applied for ______ Registration: no _______________ country letter(s) ________

Supplementary odometer: make & model ____________ electronic mechanical No of distance displays _________

HERO Declaration of Vehicle Eligibility: attached/send Guidelines and Declaration Form/HERO already has my form

Historic/rarity interest______________________________________________________________________________

________________________________________________________________________________________________

HRT Only Supplementary odometer: make & model ________________ electronic/manual
No of distance displays ______

FIA Historic Regularity Car Pass: Issuing ASN ____________________________________
Number ______________________________________ (photocopy attached)

TROPHY ELIGIBILITY (tick box(es) as applicable)

Beginners (on first-ever rally)

All-lady crew

Nationality award: country _________________________ (First driver must be resident of that country, and car registered there)

TEAM ENTRY (You may be in just one Marque or Club Team. Qualifying crews may be in more than one Golden Oldie team):

	Name of team	Other team members
Marque	___________________________________	1 _____________________	2 _____________________
Club	___________________________________	1 _____________________	2 _____________________
Golden Oldie	___________________________________	1 _____________________	2 _____________________

APPLICATION FOR ENTRY: We, the undersigned, apply to enter the 2002 London-Lisbon Classic Rally. We agree to read, understand and be bound by the Regulations for this event when they are published, and by such new or amended Regulations and instructions as may from time to time be issued. In consideration of the acceptance of this entry or of my being permitted to take part in the event, I agree to save harmless and keep indemnified any Sponsors of the event, The Historic Endurance Rallying Organisation (HERO) Ltd, the Authorising Bodies (including The Royal Automobile Club Motor Sports Association Ltd, the Fédération Internationale de l'Automobile, the Federación Española de Automovilismo, the Federação Portuguesa de Automobilismo e Karting), such person, persons or body as may be authorised by The Historic Endurance Rallying Organisation (HERO) Ltd and/or the Authorising Bodies to promote or organise this event, and their respective officials, servants, representatives and agents from and against all actions, claims, costs, expenses and demands in respect of death or injury to myself howsoever caused arising out of or in connection with this entry or my taking part in this event, and notwithstanding that the same may have been contributed to or occasioned by the negligence of the said bodies, their officials, servants, representatives or agents.

Furthermore, in respect of any parts of this event on the ground where third party insurance is not required by law this agreement shall in addition to the parties named above extend to all and any other competitor/s and their servants and agents and to all actions, claims, costs, expenses and demands in respect of loss or damage to the person or property of myself, my driver(s), passenger(s), mechanic(s), or associated personnel.

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 place on roads as defined by the law.

My age is declared below (if applicable, put ‘over 17 years’; in the case of any competitor of 17 years or under, this form must be countersigned below by his or her parent or guardian).

	Signature	Date	Age (see above)	Signature of parent or guardian (if aged 17 or under)	Date
First driver
Second driver
Third crew
Fourth crew

Crew member to whom documentation should be sent ________________________________________________

HOTEL REQUIREMENTS:
Single rooms: please book us single room(s) where available; supplement enclosed (see below) (subject to availability - will be refunded in whole or in part if single rooms not available)

Double/twin rooms: double bed preferred twin beds if possible but double bed acceptable must be twin beds
(For special requirements, telephone or fax our Accommodation Officer Harriet Batson on (+44/0) 1409 211647)

EVENT FEES (if paying by cheque or bank transfer, you may choose to pay in either GBP or Euros):

Basic CRT car entry (includes two drivers) 1995 GBP / 3500 Euro	_______
Basic TR car entry (includes two drivers) 1845 GBP / 3240 Euro	_______
Accomodation fee (for crew of two) 855 GBP / 1500 Euro	_______
Additional crew members : _______ persons @ 800 GBP / 1400 Euro per person	_______
Single room supplement: _______ persons @ 425 GBP / 750 Euro per person	_______
Team Entry Fees (15 GBP / 27 Euro per team of three cars)	_______
MINUS deposit already paid (if applicable)	_______
MINUS 100 GBP / 175 Euro discount for pre-war car (if applicable)	_______
(if paying by cheque) TOTAL ENCLOSED	_______ GBP/EURP
2% Credit Card Service Charge	_______
Total to be charged to credit card (payable in GBP only)	£ _______

Please make cheques payable to HERO. (Our bank details are: Lloyds Bank plc, 48 Belle Vue Terrace, Malvern, Worcester, WR14 4QG - UK. Bank code 30-95-41; Account number 0921536)
Mail this form, with full fees, to

Classic Malts Scottish Reliability Trial
The Town House, Leigh, Worcestershire, WR6 5LA, England
Telephone +44 (0) 1886 833505 - Fax +44 (0) 1886 833144