SEMSEC Online Sprint Entry Form

Date of event: Saturday 9th May 2009
ENTRY CLOSING DATE: 1st May 2009

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

Drivers Name: MSA Licence No.
  Type: Grade:
Drivers Address:

Postcode:

Email Address:

Telephone:
Club:
Championship:
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:
Modifications:
Engine Capacity:
 Class Entered:
 Colour:
Please indicate if the car has: Forced Induction Uses Diesel Fuel
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.

 

ELIGIBILITY DECLARATION: I DECLARE THAT THE CAR ENTERED COMPLIES WITH THE REQUIREMENTS LAID DOWN BY THE ASEMC/ACSMC/AEMC/LCAMC AND REPRODUCED IN THE SR's


I have read and accept the above declaration.

 

DECLARATION OF INDEMNITY:Held under the General Regulations of The Motor Sports Association (incorporating the provisions of the International Sporting Code of the FIA) and these Supplementary Regulations.
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.

 

State your age if under 18:

 

I declare that to the best of my belief the driver(s) possess(es) the standard of competence necessary for any 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 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 declare that the particulars given on this entry form are a true record.


I have read and accept the above declaration.