Whilton Mill Kart
Club Brazilain
Cup Charity Meeting
Affiliated to Association of British Kart Clubs
~ 2008 Race Entry Form 2008
~
Competition Secretary
Rita Chapman, 23 Foxglove Close, Castle Meadow,
Buckingham MK18 1FU Tel: 01280 816512
Date of Meeting 1st JUNE 2008
Race Class
Race meetings held under
the General Regulations of the MSA Ltd (incorporating the provisions of the
International Sporting Code of the FIA) and the Supplernentary Regulations.
Driver
(name printed in the programme):
.
.
Address:
.
..
.
Tel No:
Club:
.
.
Licence No:
.
..
NOVICE YES or
NO
.
Kart
No:
(Class To ABkC Regulations)
Transponder ID Number
...
..
Engine(s)
..
Chassis...
...
...
Fee enclosed
£40 Club Member or £45 Non Members each PLUS £10 Charity Donation
Made Payable
to WMKC. Place cheque guarantee
number on reverse of cheque.
ENTRIES
CLOSE SATURDAY ONE WEEK PRIOR TO THE EVENT
Send SAE or e-mail address
...............................................................................................................................................or
Confirmation
SORRY BUT NO S.A.E. NO CONFIRMATION OTHER THAN
EMAIL. ENTRIES CLOSE SATURDAY ONE WEEK PRIOR TO THE EVENT
Name of Person to be contacted in case of Emergency:…………………………………………………………
Address:………………………………………………………………………………………………………………...
…………………………………………………………………………Tel:……………………………………………
I have read the supplementary regulations
issued for this event and agree to be bound by them and by the General
Regulations of the Motor Sports Association Ltd. In consideration of the
acceptance of this entry and of my being permitted to take part in this
event, in respect of any parts of the event not held on publicly adopted
road, I agree to save harmless and keep indemnified the Motor Sports
Association Ltd. Such person,. persons or body as may be authorised by The
Motor Sports Association Ltd to promote or organise this event and their
respective officials, servants, representatives and agents, together with
other competitors and their respective servants, representatives and
agents, from and against all actions, claims, costs, expenses and demands
in respect of death of or injury to or damage to the property of myself my
driver(s), passenger(s), mechanic(s) or associated personnel arising out
of or in connection with this entry or my taking part in this event. I
also agree to abide by the ABkC regulations as set down in the MSA Kart
Race Yearbook.
My age is…………....….(if
applicable state Over 18 years )
I declare that to the best of my belief the driver(s)
possess(es) the standard of competence necessary for an event of this type
to which this entry relates and that the vehicle entered is suitable and
road worthy for the event having regard to the course and 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 effect prejudicially my normal control of my vehicle, I may not
take part unless I have declared such disability to the Motor Sports
Association Ltd who have, following such declaration, issued a licence
which permits me doing so.
I undertake that at the time of the event
to which this entry relates I shall be in possession of a current valid
MSA approved Medical Certificate.
You must be in possession of a Club Membership Card and an MSA Competition Licence in order to take part in a race meeting.
Signed..............................................: Counter Signed Drivers under 18 years only..................................................
Address of Counter Signatory:..........................................................................................................................................
IF THE PARENT OR GUARDIAN IS NOT AT THE MEETING WITH UNDER 18 DRIVERS, WILL YOU MAKE SURE THAT THE PERSON RUNNING THE DRIVER HAS YOUR WRITTEN AUTHORITY TO ACT ON YOUR BEHALF
ELECTRONIC TRANSMISSION IS NOW ACCEPTABLE BUT THIS ENTRY FEE MUST BE SENT BY POST