SEMSEC Online Entry Form

Saturday 4th June 2011 Lydden
STANDARD ENTRY CLOSING DATE: 25 May 2011 – Late Entry Closing Date: 1st June 2011.
(LATE ENTRY SURCHARGE OF £25 DUE FOR ALL ENTRIES RECIEVED AFTER THE STANDARD ENTRY CLOSING DATE).

Payment is taken by PayPal. You do not need a PayPal account.

Drivers Name:

MSA Licence No.

Drivers Address:

Postcode:

Email Address:

Telephone:

Club:

ENTRANT DETAILS (if not the driver):

Entrant Name:

MSA Licence No.

Address to which passes should be sent if different to above:

ALL DRIVERS – IN CASE OF ACCIDENT:

Address:

Name:

Telephone:

CAR DETAILS:

Make:

Model:

Engine/Tuner:

CC:

Forced injection: Yes No

Regular Competition No.

Transponder Number.

RACES ENTERED:

	Standard Entry Fee	Races Entered	Class Entered
Closed Wheel Cars
A. SEMSEC Saloon & Sports Car Championship Race (Double Header) (Part of the SEMSEC Saloons & Sports Championship)	£225
B. SEMSEC Sports Racing & Kit Car Championship Race (Double Header) (Part of the SEMSEC Saloons & Sports Championship)	£225
D. Invicta Kit Car Challenge (Entry to ‘E’ included) (£170 if entering A or B above)	£225
E. South East Challenge Race (Do not select if ‘D’ above selected)	£160
F. Meridian 14/16 Challenge	£100
Single Seater Cars
C. SEMSEC Open Single Seater Championship Race (Double Header)	£225
Invitation Race
I. MGCC Midget Challenge (contact Larry Quinn of MGCC)	N/A

Would you like to make a donation to the Marshals Fund?	£5
NOTE: IF YOU HAVE NOT TICKED THE RACE ENTERED AND INDICATED THE CLASS YOU WISH TO ENTER WE WILL NOT PROCESS YOUR ENTRY. It is the competitor’s responsibility to read the technical regulations for the championship/challenge or race being entered and decide which class their car is eligible for. Club officials will NOT do this for you. Technical regulations can be viewed on this website or may be requested from the club at SEMSEC, Greenfields, 16 Saxonbury Close, Crowborough, East Sussex, TN6 1EA

ENTRY FEES

First Race Entry Fee	£
Additional Race Entry Fee (£110.00 single race £170 double header)	£
Further Additional Race Entry Fee (£60.00)	£
Late Entry Surcharge (£25.00)	£
Donation to the Marshals Fund	£
PayPal Surcharge	£

TOTAL	£

DECLARATION

ALL DRIVERS WILL BE REQUIRED TO SIGN A DECLARATION ON THE DAY.
Entrants not attending the event should printout and return this declaration.

Drivers/Entrants under 18 require the permission of a Parent/Guardian. Printout and return this form for Parent/Guardian permission.

Held under the General Regulations of the Motor Sports Association (incorporating the provisions of the International Sporting Code of the FIA), these Supplementary Regulations and any written instructions that the organising club may issue for the event.
GENERAL DECLARATION - FOR COMPLETION BY ALL ENTRANTS AND DRIVERS
I declare that I have been given the opportunity to read the General Regulations of the Motor Sports Association and, if any, the Supplementary Regulations for this event and agree to be bound by them. I declare 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 motor sport 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.

DECLARATION TO BE COMPLETED BY ENTRANTS: I declare that to the best of my belief the Driver(s) possess(es) the standard of competence necessary for an event of the type to which this entry relates and that the vehicle entered is suitable and roadworthy for the event having regard to the course and the speeds which will be reached.

I have read and accept the above declaration.

DECLARATION TO BE COMPLETED BY DRIVERS: I understand that should I at the time of this event be suffering from any disability whether permanent or temporary which is likely to affect prejudicially my normal control of my vehicle, I may not take part unless I have declared such disability to the ASN which has, following such declaration, issued a licence which permits me to do so. I undertake that at the time of the event to which this entry relates I shall have passed or am exempt from an ASN specified medical examination within the specified period.

I have read and accept the above declaration.

Enter the code shown above in the box below.