Vehicle Entry Form

THE PROVINCIAL SOCIETY RALLY STOKES BAY

Sunday 6th August 2017

VEHICLE ENTRY FORM

Name: …………………………………………………. Society/Company (if applicable)………………………………………..…….…………………

Address: …………………………………………………………………………………………..…………………………..……………………………………………

……………………………………………………………………………………………………………………… Postcode: ………………………………………….

Phone No: Day: …………………………....……..…. Evening:……………..…………..………………Mobile:………………….………….…………

Email Address:…………………………………………………………………………………………………………………………..……………………………..

VEHICLE ENTRY DETAILS

Registration No: …………………………..……………………… Year Built:…………………………………..

Chassis Make:…………………………………………………………….. Model:……………………………………………….…………………………………

Body Make/Type:…………………………………………………………… Capacity:…………………………… (eg. B45F/H40/30R/C53F, etc)

Operator:……………………………………………………….………………………… Fleet No:………………………………….……………………………..

Brief History: (continue overleaf if necessary):………………………………………………………………………….……………………………….

……………………………………………………………………………………………………………………………………………………………………………………

……………………………………………………………………………………………………………………………………………………………….…………………..

Are you willing to make your vehicle available for public rides? YES / NO (delete as applicable)

Is so, please indicate preferred times:………………………………………………………………………………………………………………………..

Do you intend to take part in the Cavalcade? YES / NO (delete as applicable)

Notes: 1. Entries received after the 12th July may not appear in the Rally Programme.

2. Due to the insurance requirements no sales will be permitted from vehicles

Advisory note for bus entrants willing to run in service:

The Provincial Society is adhering to the recommended guidelines published by the National Association of Road Transport Museums (NARTM) in regard to the status of vehicle(s) and driver(s). Vehicles registered after 7th January 1960 must have a current MoT Class 5 or Class 6 certificate. Vehicles registered before this date are now exempt from MoT but can only be accepted with proof of their roadworthiness by an independent and competent vehicle examiner who has examined the vehicle in accordance with the DVSA inspection manual. Vehicles used in service must have insurance that covers full passenger loads. A copy of your insurance and MoT (or alternative) must accompany this application and further evidence of the latest certificates must be presented to our marshal for inspection on the day. All rear entrance vehicles used in service must carry a conductor and all vehicles are to be driven by holder with the appropriate licence.

Declaration for bus entrants willing to run in service:

I declare that the vehicle entered is taxed, insured to cover public liability of not less than £500,000 for any one accident and is adequately insured to cover public bus rides. I also confirm that the driver(s) of the vehicle currently hold(s) an appropriate class PCV licence. I confirm that the vehicle has a current MoT certificate or, if exempt, I can provide evidence of roadworthiness by an independent examiner within the last twelve months. Email signatures will be deemed acceptable. I confirm that I/we will conform with the directions given on the day by staff of the Provincial Society.

Site Speed Limit - The maximum speed limit on site 5mph.

Signed: …………………………………………….. Name (please print): ……………………………… Date: …………………………………….

Submission by email to confirms that you comply with the above declaration.

Please return completed form to: Gerry Tormey, 30 Wises Court, Mumby Road, Gosport, Hants PO12 1DD