Car Trial 2024 Entry Form

Please complete this form for each driver if you are sharing a car.
Make sure that the driver (and passenger) have a current competition licence or have applied for one before continuing. You will also need to know which class you are entering (see Regs).

Driver Name:*

First

Last

Motorsport UK Licence Number (Driver):

Driver Address:

Street Address Street Address Line 2 City County Post Code

Phone Number:

E-mail for final instructions:*

Club:*

Motorsport UK Championship Contender:

BTRDA Championship Contender:

ANWCC Championship Contender:

Driver Emergency Contact Name:*

Driver Emergency Contact Phone:

Driver Emergency Contact Address:

Driver Age:*

Name of Parent or Guardian (Driver):

First

Last

Parent/Guardian Address (Driver):

I understand that I shall have the right to be present during any procedure carried out under the Supplementary Regulations issued for this event and The General Regulations of Motorsport UK. I confirm that I have acquainted myself and the minor with Motorsport UK 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.

P/G Declaration (Driver):

I accept this declaration:

Passenger Details (scroll down if none) (just enter passenger name here if sharing a car and make sure a separate entry is submitted for each driver)

Passenger Name:

First

Last

Motorsport UK Licence Number (Passenger):

Passenger Address:

Street Address Street Address Line 2 City County Post Code

Passenger Club:

Passenger Emergency Contact Name:

Passenger Emergency Contact Phone:

Passenger Emergency Contact Address:

Passenger Age:

Name of Parent or Guardian (Passenger):

First

Last

Parent/Guardian Address (Passenger):

I understand that I shall have the right to be present during any procedure carried out under the Supplementary Regulations issued for this event and The General Regulations of Motorsport UK. I confirm that I have acquainted myself and the minor with Motorsport UK 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.

P/G Declaration (Passenger):

I accept this declaration:

Entry Type:*

Class:*

Car Make:*

Car Model:*

Capacity (c.c.) :*

If you are sharing the car please give the name of the other driver:

I declare that I have been given the opportunity to read the General Regulations of the Motorsport UK 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 motorsport 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 any one of or any combination of Motorsport UK 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 but not limited to damage to property, economic loss, consequential loss or financial loss howsoever caused. 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.
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 fully understood the regulations for Control of Drugs and Alcohol as contained in the Competitors’ and Officials’ Yearbook Regulations C1.1.7, D35.1, G15.1.4, H38 and have also fully familiarised myself with the information on the web sites referred to (www.motorsportuk.org, www.ukad.org.uk and www.wada-ama.org) in particular the UK Anti Doping Rules which have been adopted by Motorsport UK.
I hereby agree to abide by the Motorsport UK Safeguarding Policy and Guidelines and the National Sporting Code of Conduct.
Under the provision of GDPR 2018, the Airedale and Pennine Motor Car Club Ltd require your permission to hold the information on this entry form on a computer for the purpose of producing address lists, results and other such data for running the trial. Your acknowledgement below gives the organisers the right to store this information on a computer.

Declaration (please tick):*

I Accept

Total:

I will be paying by:*

BACS

Cheque in the post

Card

Please make cheques payable to "Airedale and Pennine MCC"
If the drivers name is not on the cheque please write it on the back and send to:
Russell Coppin
85 Dalecroft Rise
Bradford
West Yorkshire
BD15 9AT

Please set up a bank transfer to Airedale and Pennine Motor Car Club using the following details and for the total amount shown above.
Sort Code: 20-78-42
Account Number: 93735796
Put the drivers name as the reference so we know who the money has come from.

Event Entries Website

Airedale and Pennine Motor Car Club Ltd.

Passenger Details (scroll down if none) (just enter passenger name here if sharing a car and make sure a separate entry is submitted for each driver)

Please make cheques payable to "Airedale and Pennine MCC"
If the drivers name is not on the cheque please write it on the back and send to:
Russell Coppin
85 Dalecroft Rise
Bradford
West Yorkshire
BD15 9AT

Please set up a bank transfer to Airedale and Pennine Motor Car Club using the following details and for the total amount shown above.
Sort Code: 20-78-42
Account Number: 93735796
Put the drivers name as the reference so we know who the money has come from.

Please click Submit first.
A link to Stripe for paying by card is in the menu above.

Passenger Details (scroll down if none) (just enter passenger name here if sharing a car and make sure a separate entry is submitted for each driver)

Please make cheques payable to "Airedale and Pennine MCC"If the drivers name is not on the cheque please write it on the back and send to:Russell Coppin85 Dalecroft RiseBradfordWest YorkshireBD15 9AT

Please set up a bank transfer to Airedale and Pennine Motor Car Club using the following details and for the total amount shown above.Sort Code: 20-78-42 Account Number: 93735796Put the drivers name as the reference so we know who the money has come from.

Please click Submit first.A link to Stripe for paying by card is in the menu above.

Please make cheques payable to "Airedale and Pennine MCC"
If the drivers name is not on the cheque please write it on the back and send to:
Russell Coppin
85 Dalecroft Rise
Bradford
West Yorkshire
BD15 9AT

Please set up a bank transfer to Airedale and Pennine Motor Car Club using the following details and for the total amount shown above.
Sort Code: 20-78-42
Account Number: 93735796
Put the drivers name as the reference so we know who the money has come from.

Please click Submit first.
A link to Stripe for paying by card is in the menu above.