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Autotest October 2017 Entry Formmediaistic2017-10-04T13:12:12+01:00

Step 1 of 4

25%
  • About the Driver

    We need to collect some information about the driver. Please ensure you fill this form out with as much accuracy as possible.
  • if different to above





  • About Your Club

    Please let us know which club you are a member of, and your membership number.





  • Drivers Emergency Contact

    Please let us know who to contact in the event of an accident or emergency.
  • About the Passenger / Navigator

    We need some details about your passenger / navigator.
  • if different to above





  • About Your Passengers Club

    Please let us know which club your passenger is a member of, and their membership number.





  • Passengers Emergency Contact

    Please let us know who to contact in the event of an accident or emergency.
  • About Your Entry

  • Indemnification & Declaration

    You will be required to sign a copy of this at the event. If you or your passenger are under the age of 18 - a parent or legal guardian must also sign the form.
  • 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. I understand that motor sport can be 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. In consideration of the acceptance of this entry I agree that neither anyone of or any combination of the MSA and its associated clubs, the organisers, the track 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 the event including not limited to damage to property, economic loss, consequential loss or financial loss howsoever caused. Nothing in this clause is in 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. ‘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 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.
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Registered Company No. 01267498 - Trudgeon Halling, The Platt, Wadebridge, Cornwall, PL27 2AE (do not use this address for correspondence)
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