Entry Form, Froude Solo 2017 – Saturday 7th October
Southern Car Club Limited (SCC) will promote a Dual Permit National B & Clubman AutoSolo event on Saturday 7th October, at Kempton Park Racecourse, Sunbury on Thames, Middlesex TW16 5AQ. The event is kindly sponsored by the Froude Family

The event will be governed by the 2017 General Regulations of the Royal Automobile Club Motor Sports Association Limited (MSA) 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

The entry fee is £45 per driver or £15 for drivers under 21. Entries sent after Friday 29th September must add £5.

Southern Car Club members that are under 25, but over 21, will have a 25% discount applied and their entry fee is £33.75- with thanks to the Brian Hugh Fund.

SCC members under 25 get 25% off joining fees, club fees, event fees* and social events. Membership forms are available on the SCC website.

Event Regulations are published here: http://southerncarclub.com/wp-content/uploads/2017/08/Regulations-Froude-Solo-20170814.pdf

Email addresses are required so you receive a copy of your entry form and so we can send final instructions and results.

Email address
DRIVER DETAILS
Full Name
Your answer
Full Postal Address with Post Code
Your answer
Telephone contact Number
Your answer
Date of Birth if under 17, else ignore.
MM
/
DD
/
YYYY
Do you hold a current RTA (Driving) Licence?
PASSENGER (only for drivers with no RTA licence)
Passenger Name
Your answer
Passenger Experience or N/A
Is passenger Experienced in Autotest or Autosolo?
CLUB DETAILS
You will need to show a valid Club Membership card at event registration.
Club (please contact the secretary if your club is not invited):
You must be a Member of an MSA recognised Club. Re-read the regulations if you need to join a club, or contact Southern Car Club Membership Secretary to join quickly. Details on our website http://southerncarclub.com/?page_id=1471
Your answer
Please indicate if you are an ACSMC championship contender:
EMERGENCY CONTACT DETAILS - DRIVER
Name & Relationship
Your answer
Address & Telephone
Your answer
EMERGENCY CONTACT DETAILS - PASSENGER
Name & Relationship
Your answer
Address & Telephone
Your answer
DOUBLE DRIVE
Each driver must complete a separate entry form.
Other driver if sharing car (Double Drive)
CAR DETAILS
Make
Your answer
Model
Your answer
Registration Number
Your answer
CCs
Cubic capacity e.g. "1598" , just enter the numeric digits
Your answer
Fuel
Forced Induction (Turbo or Supercharged)
Class
You are confirming that your car is eligible for this class. See notes in Regs.
PAYMENT DETAILS
PayPal - Online Payment via "Buy Now" button from Event Entry Page http://southerncarclub.com/?page_id=7912#paynow. You can use PayPal with a Credit or Debit card and you do not need a PayPal account.

Cheques - Payable to "Southern Car Club"

Payment Method
DECLARATION of INDEMNITY
Please read the Declaration Page from the Entry Regulations
Required
PARENTAL CONSENT
For all drivers/passengers under 18 years of age, this form must be completed.

13.1.1 (c): I am the Parent/Guardian/Guarantor of the driver/passenger ‘I understand that I shall have the right to be present during any procedure being carried out under the Supplementary Regulations issued for this event and the General Regulations of the MSA.’ As the Parent/Guardian/Guarantor ‘I confirm that I have acquainted myself with the MSA General Regulations, agree to pay any appropriate charges and fees pursuant to those Regulations (to include any appendices thereto) and hereby agree to be bound by those Regulations and submit myself without reserve to the consequences resulting from those Regulations(and any subsequent alteration thereof).Further, I agree to pay as liquidated damages any fines imposed upon me to the maxima set out in Part 3 Appendix 1’

Parent or Guardian of:
Your answer
Parent or Guardian Name & Relationship to Competitor
Your answer
Parent or Guardian Address & Telephone Number
Your answer
Consent
Parental Consent Authorisation
In the event that the Parent/Guardian of the young person not being present on the day ALSO COMPLETE the additional form located here (http://southerncarclub.com/wp-content/uploads/2017/08/Parental-Consent.pdf) and return it to the event secretary.

By post: Michael Russell, 39 Regent Court, Norn Hill, Basingstoke RG21 4HP
Scanned and emailed: itofficer@southerncarclub.com

Will the Parent or Guardian of the young person be present on the day?
END OF FORM
A copy of your responses will be emailed to the address you provided.
Please complete the captcha before submitting the form.
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Additional Terms