Entry Form – Lydden Classic Festival Fields marked with an * are requiredDriver DetailsName* Forename Surname Address* Street Address Address Line 2 Town County Post Code CTCRC membership*I will be applying for weekend membership (£15.00)I am already a memberCTCRC Membership NumberEmail* Telephone*Mobile (at circuit)*Competition Licence No.*Grade*To comply with MSA requirements, any Driver competing in a vehicle of 0.34bhp/kg or higher (excluding driver weight) and measured at the driven wheels must be the holder of a Race National ‘A’ licence, as a minimum.Is the Driver taking any prescribed medication or suffering from any condition which should be notified to the medical team?*YesNoIf Yes, Please give detailsNext of Kin Name*Relationship to Driver*Home Phone*Mobile PhoneI declare that: 1. I have been given an 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 and competent to take part in the event. I understand that motorsport is dangerous and accidents causing death, injury, disability and property damage can and do happen. I understand that these risks may give rise to my suffering personal injury or other loss and I acknowledge and accept these risks. 2. 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. 3. The use of the vehicle hereby entered is 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. 4. 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 the 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. 5. Any application form for a Licence which was signed by a person under the age of 18 years was countersigned by that person’s parent/legal guardian/guarantor, whose full names and addresses have been given. 6. 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. Note: Where the Parent/Guardian/Guarantor is not present there must be a representative who must produce a written and signed authorisation to so act from the Parent/Guardian/Guarantor as appropriate. 7. I hereby agree to abide by the MSA Child Protection Policy and Guidelines an d the National Sporting Code of Conduct. 8. I undertake that at the time of the event to which this entry relates I shall have passed or am except from an ASN specified medical examination within the specified period. (H10.1.6) 9. I have read and fully understood the Procedure for Control of Drugs and Alcohol as contained in the MSA Yearbook Regulations H39, D35.1, G15.1.4 and have also fully familiarised myself with the information on the web sites referred to (www.ukad.org.uk and www.wada-ama.org) in particular the UK Anti-Doping Rules which have been adopted by the MSA (as amended). Further, if I am counter-signing as the Parent or Guardian of a minor then in addition to the deemed consent to the testing of that minor (Art 5.6.2) I hereby confirm that I give such consent for the minor concerned to be so tested. Indemnity: In consideration of the acceptance of this entry I agree that neither any one of or any combination of the MSA and its associated clubs, the organisers, the land owners or other occupiers, the promoters and their respective officers, servants, representatives and agents (the “Parties”) shall have any liability for loss or damage which may be sustained or incurred by me as a result of participation in this event. Nothing in this clause is intended to or shall be deemed to exclude or limit liability for death or personal injury. To the fullest extent permitted by law I agree to indemnify and hold harmless each of the Parties in respect of any loss or damage whatsoever and howsoever arising from my participation in this event.Driver Signature*Type X into the box, form to be signed on the day.Date* Age if under 18Any indemnity and/or declaration as described by the paragraphs above which is signed by a person under the age of 18 shall be countersigned by that person's parents or guardian, whose full name and address is given below. Name of Parent/GuardianSignature of Parent GuardianType X into the box, form to be signed on the day.Parent/Guardian Address Street Address Address Line 2 Town Postcode Vehicle DetailsFields marked with an * are requiredMarque*Model*Engine Size (cc)*Transponder No.*Competition Number*Racing Class*Team Name/Sponsor InfoEntrant DetailsNB: This section is only to be completed if a valid Entrants Licence has been issued by your ASN. If no Entrant Licence is held then the Driver whose details have been entered in Section 1 will be automatically nominated as the Entrant in conjunction with MSA Regulation (H1.3). Entrant Name First Last Entrant Address Street Address Address Line 2 Town Postcode Entrant SignatureType X into the box, form to be signed on the day.Entrant Email PhoneMobileEntrant Licence NumberASNRace EnteredFirst Championship/Race Entered*The cost is £249 for 1 qualifying and 2 x 15 min races. All on a single day. If you wish to race in a second championship and the car is eligible then it’s an extra £75. Drivers are welcome to bring a second car to the event which will be covered under the £75 offer. Weekend membership for non-members is £15.Pre-66 touring Cars (Pre 1966)Group 1 Touring Car Championship (Pre 83)Pre-1993 Touring Cars (Pre 93)Classic Thunder SaloonsBlue Oval Saloon Series (BOSS)Pre-2005 Production Touring Car Championship (Pre 2005)Pre-2003 Production Touring Car Championship (Pre 2003)Pre 2003 Classic VW CupHonda VTEC ChallengeSmart Car ChallengeAll Comers Race (including Thunder)Do you wish to race in a second championship? Yes Second Championship/Race Entered*Pre-66 touring Cars (Pre 1966)Group 1 Touring Car Championship (Pre 83)Pre-1993 Touring Cars (Pre 93)Classic Thunder SaloonsBlue Oval Saloon Series (BOSS)Pre-2005 Production Touring Car Championship (Pre 2005)Pre-2003 Production Touring Car Championship (Pre 2003)Pre 2003 Classic VW CupHonda VTEC ChallengeSmart Car ChallengeAll Comers Race (including Thunder)Second Vehicle DetailsFields marked with an * are required2nd Car Marque*2nd Car Model*2nd Car Engine Size (cc)*2nd Car Transponder No.*2nd Car Competition Number*2nd Car Racing Class*2nd Car Team Name/Sponsor InfoMarshals FundWould you like to make a donation to the Marshals Fund?Yes (£5)NoTotal: £ 0.00 Championship Registration DeclaredI have registered for the 2017 Classic Touring Car Championship and have been issued a Race Number via the Championship Co-Ordinator. I agree to abide by all the Sporting and Technical regulations produced by the CTCRC, BARC and the MSA, including any amendments or clarifications that may be made by these parties throughout the 2017 season. Driver Signature*Type X into the box, form to be signed on the day.Date* PhoneThis field is for validation purposes and should be left unchanged.