Name *

First

Last

Registration *

• Standard Registration €40.00
• Junior €25.00
• J1000 €15.00

Competitor Type *

• Driver
• Co-Driver

Date of Birth *

Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

IrelandAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBolivia (Plurinational State of)Bonaire, Saint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCongo (Democratic Republic of the)Cook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Kingdom of)EthiopiaFalkland Islands (Malvinas)Faroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHondurasHong KongHungaryIcelandIndiaIndonesiaIran (Islamic Republic of)IraqIreland (Republic of)Isle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea (Democratic People's Republic of)Korea (Republic of)KosovoKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesia (Federated States of)Moldova (Republic of)MonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth Macedonia (Republic of)Northern Mariana IslandsNorwayOmanPakistanPalauPalestine (State of)PanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint Martin (French part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint Maarten (Dutch part)SlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyrian Arab RepublicTaiwan, Republic of ChinaTajikistanTanzania (United Republic of)ThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUgandaUkraineUnited Arab EmiratesUnited Kingdom of Great Britain and Northern IrelandUnited States Minor Outlying IslandsUnited States of AmericaUruguayUzbekistanVanuatuVatican City StateVenezuela (Bolivarian Republic of)VietnamVirgin Islands (British)Virgin Islands (U.S.)Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland IslandsCountry

Email (parents or guardians if under 18) *

Mobile Number (parents or guardians if under 18) *

Competition Licence Number *

Licence Grade *

Issuing Association *

• Motorsport Ireland
• MSA
• Other

Car Make & Model *

Car Registration Number *

Engine Cubic Capacity *

Valves Per Cylinder *

• Two vales per cylinder
• More than two valves per cylinder

Turbo *

• Yes
• No

2 Wheel Drive OR 4 Wheel Drive *

• 2 Wheel Drive
• 4 Wheel Drive

Grp N *

• No
• Yes

Grp R *

• Yes
• No

Group Entered (see article 4) *

• Group J1000 – 15,00 €
• Group 1 – Juniors – 25,00 €
• Group 2 – 40,00 €
• Group 3 – 40,00 €
• Group 4 – 40,00 €
• Group 5 – 40,00 €
• Group 6 – 40,00 €
• Group 7 – 40,00 €

Choose your Nominated Event for Double Points 2024 (see article 7)

• Round 1: Carrick on Suir – Willie Loughman Forestry Rally – 14th April
• Round 2: Wexford Rallysprint – 16th June
• Round 3: Tipperary Stonethrowers Rally – 14th July
• Round 4: Carrick on Suir Rallysprint – 25th August
• Round 5: Wexford Volkswagen Stages Rally – SATURDAY 14th September
• Round 6: Wexford Volkswagen Stages Rally – SUNDAY 15th September
• Round 7: Clare Motor Club Forestry Rally – 5th October
• Round 8: Laois Rallysport Club Loose Surface Rallysprint – 16th October
• Round 9: Carlow Rallysprint – 27th December

Club Member *Choose your club by clicking hereCarlow Car ClubCarrick on Suir Motor ClubClare Motor ClubLaois Rallysport ClubMunster Car ClubTipperary LC & MCWexford Motor ClubOther

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