Safari Scatter

27th/28th March 1999

Regulations Entry Form Final Instructions Results Home

The Windsor Car Club Safari Scatter

27th/28th March 1999

Entry Form

Driver

Navigator

Name

Address

Tel. No.

Club

Next of Kin: Name

Tel. No.

Additional Navigators:

Names:


Vehicle Details

Name and Address of Insurers

Make:

Model:

Colour:

Registration:

Class Entered? Novice or Semi-Expert or Expert

Correspondence to ? Driver or Navigator

 

 

Tick

[ ] Entry Fee £6.00 Please return to:
[ ] Late entry supplement £4.00 Doug Robinson
[ ] WCC Membership (driver) £11.00 84 Commercial Street
[ ] WCC Membership (navigator) £11.00 Bitterne
Southampton
Total Enclosed £ SO18 6NJ

Please make cheques payable to "Windsor Car Club Ltd".

Remember to sign the indemnification below

The Windsor Car Club Safari Scatter

27th/28th March 1999

Entry Form

Please sign the declaration below, complete the details above and return to the Entries Secretary with your entry fee.

Declaration of Indemnification

"I have read the Supplementary Regulations issued for this event and agree to be bound by them and by the General Regulations of The RAC Motor Sports Association Ltd. In consideration of the acceptance of this entry and my being permitted to take part in this event, in respect of any parts of the event not held on a publicly adopted road, I agree to save harmless and keep indemnified The RAC Motor Sports Association Ltd., such Person, Persons or Body as may be authorised by The RAC 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 declare that the use of the vehicle hereby entered will be covered by insurance as required by the law which valid for such part of this event as shall take place on roads as defined by law."

Driver:

Signed:

Date:

State your age if you are under 18:

Navigator:

Signed:

Date:

State your age if you are under 18:

If the entrant, driver or navigator is under 18 years of age, this form must be countersigned by the appropriate parent or guardian.

Parent or Guardian

Signed:

Date:

Full Name:

Address:



Official Use Only:

Entry Number

Date Received

Class

Membership Required





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