AMCA Winter Chmp Trial
SCTC at Birchwood Farm Rd 9
Sunday 22 February 2015
Venue Birchwood Farm Shatterford
Directions Signed off A442 Kidderminster to Bridgenorth Road, 3m out of Kidderminster on . right hand side before fishery
Post code DY12 1TP
Start Sunday 11am
Classes Expert / Clubman / Non Expert / Twin Shock A/Twin Shock B
Entry Fee AMCA licence Holders £8 post £10 on day
Guest £10
Entries to Mr J Bottrill 28 Emmanuel Road Burntwood Staffs WS7 9AD
Tel 01543 684967 Email This email address is being protected from spambots. You need JavaScript enabled to view it.
Cheques Payable SCTC
AMCA Winter ChmpTrial
Birchwood Farm
Sunday 22nd February 2015
Christian Name........................................................Surname..........................................
Address..............................................................................................................................................................................................................................................................................................................................E-Mail.............................................
Tel........................................................................AMCA Licence..................................
Club......................................................................Machine...........................................
Grade: Expert / Clubman / Non Expert / Twin Shock A (Club R)/Twin Shock B (Nov R)
Also tick if guest
INDEMNITY
HELMETS TO BE WORN AS PER AMCA RULES
Declaration: Motor Sport can be dangerous and may involve injury or death. You must read and agree to the following declaration and paragraphs below which are designed to create a legally binding relationship in return for you being allowed to enter and compete.
1 I confirm that the information in this entry form and the information and my acceptance of the terms of my competition licence are correct
2 I confirm that I that I understand the nature of the competition I am entering and I am competent to take part.
3 I confirm that any vehicle I use will comply with the regulations and will be safe and fit for use in the competition
4 Before taking part in the event I will ensure ( Unless prohibited ) that I have inspected the venue, the track and the facilities and geographical features and that I am satisfied that it is safe for me to compete.
5 I will not take part if I have any doubt about my ability or the safety of the venue.
6 I accept that the competition in motor sport may involve the risk of injury or death and agree to take part at my own risk.
7 Before taking part in the event I will read and be bound by and comply with general regulations, any supplements and final instructions issued by the AMCA, the organisers and the circuit owners and the regulatory body
8 I will not participate whilst under the influence of alcohol or intoxicating drugs and that if I am taking any prescribed medication I will inform the event organiser and seek approval to participate before taking part.
9 If under the age of 18, my parent / guardian has read the above and signed the declaration below.
Entrants Signature.........................................................................................................Date..........................................................
Please complete box below for entrant under 18 years
RESULTS WILL BE POSTED ON THE WEBSITE LISTED BELOW
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