Seafield Navigational Rally 63 Car Club 15/09/2018
Held under the General Regulations of The Motor Sports Association (incorporating the provisions of the International Sporting Code of the FIA).
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 that 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 the competition and the potential risk inherent with motor sport and agree to accept that risk.
State your age if you are under 18
If I am the Parent/Guardian/Guarantor of the driver ‘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 up to the maxima set out in Part 3, Appendix 1.
IF A COMPETITOR IS UNDER 18 YEARS OF AGE THIS FORM MUST BE COUNTERSIGNED BY THE APPROPRIATE PARENT/GUARDIAN/GUARANTOR.(Please use paper form)
I declare that the use of the vehicle hereby entered will be covered by insurance as required by the law which is valid for such part of this event as shall take place on roads as defined by the law.
I have read and agree to the above statement *
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Driver Name
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Email
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Address
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Phone number
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Club
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Next of Kin (Name/Number)
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MSA Licence Number (NAT B Only)
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Navigator Name
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Email
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Address
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Phone Number
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Club
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Next of Kin (Name/Number)
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MSA Licence Number (NAT B Only)
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Event Entered
Class
Car Make / Model
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Car Reg Number
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Insurance
Payment Method - Entry Fee £20 (plus £25 event Insurance if required)
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