Online Entry Form
Saturday 25th July 2009 – Lydden Hill Circuit Kent

ENTRY CLOSING DATE: 22nd July 2009
(LATE ENTRY SURCHARGE OF £25 DUE FOR ALL ENTRIES RECEIVED AFTER THE ENTRY CLOSING DATE).

Payment is taken by PayPal. Credit Cards are Accepted.
You do not need a PayPal account in order to use the system.

Drivers Name:

Club & Membership No.

MSA Licence No.

Grade:

Drivers Address:

Postcode:

Email Address:

Telephone:

Do you have a medical condition, or are you taking any prescription drugs that you believe our Medical Officers should know about (This information will be treated in strict confidence): Yes No

ENTRANT DETAILS (if not the driver):

Entrant/Sponsor/Team Name:

MSA Licence No.

Address to which passes should be sent if different to above:

ALL DRIVERS – IN CASE OF ACCIDENT:
Please give name, address and telephone number of a relative or friend to be contacted.

Address:

Name:

Telephone:

Relationship:

CAR DETAILS:

Make:

Model:

Year:

Engine/Tuner:

CC:

Forced injection: Yes No

Racing (Car) No.

Transponder Number.

Raced at this circuit before: Yes No
Licence to be signed: Yes No

RACES ENTERED:

		Standard Entry Fee	Races Entered	Class Entered
1.	Thermex Classic & Historic Touring Car Series (Double Header) - 2 x 15 mins	£200
2.	Autoglym Post Historic Touring Car Championship - 15 mins	£150
3.	Hammerite Classic Group One Touring Car Championship - 15 mins	£150
4.	Track and Race Cars Pre ‘93 Saloon Car Championship - 15 mins	£150
5.	Impressions Classic Thunder Championship incorporating the BOSS Series - 15 mins	£150
6.	BOSS Series - 15 mins	£75
7.	CTCRC Saloon & Sports Car Challenge Races - 2 x 15 mins	£220

Would you like to make a donation to the Marshals Fund of at least £5 please?		£

ENTRY FEES

First Race Entry Fee	£
Additional Race Entry Fee (£90.00)	£
Further Additional Race Entry Fee (£60.00)	£
Late Entry Surcharge (entries received by after 22/7/09 – £25.00)	£
Donation to the Marshals Fund	£
PayPal Fee (£)	£

TOTAL	£

DECLARATION

ALL DRIVERS WILL BE REQUIRED TO SIGN A DECLARATION ON THE DAY.
Entrants not attending the event should print out and return this declaration.

Drivers/Entrants under 18 require the permission of a Parent/Guardian. Print out and return this form for Parent/Guardian permission.

The meeting will be held under the General Regulations of the Motor Sports Association (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.

GENERAL DECLARATION - FOR COMPLETION BY ALL ENTRANTS AND DRIVERS
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.

DECLARATION TO BE COMPLETED BY ENTRANTS: I declare that 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.

I have read and accept the above declaration.

DECLARATION TO BE COMPLETED BY DRIVERS: 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 undertake that at the time of the event to which this entry relates I shall have passed or am exempt from an ASN specified medical examination within the specified period.

I have read and accept the above declaration.

Online Entry Form Saturday 25th July 2009 – Lydden Hill Circuit Kent

Online Entry Form
Saturday 25th July 2009 – Lydden Hill Circuit Kent