Car Online Entry Form | Event Entries Website

Event: Yorkshire Dales Classic Reliability Trial
Date of Event: Sunday 12th May
Clubmans Permit Number: applied for
Route Authorisation No: applied for

Please make sure you have the following details to hand:
Motorsport UK Licence number
Passenger Details
Car Details
Which class you are entering, details are available in the Regs.
Debit/Credit Card if paying by card

Driver Name:*

First

Last

Driver Address:

Street Address Street Address Line 2 City County Postal Code

Driver Phone Number:

E-mail for final instructions:*

Driver Club:*

Novice (never won a classic trial award):*

Motorsport UK Licence Number:*

Driver ACTC Championship Number:

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):

Street Address Street Address Line 2 City County Post Code

I understand that I shall have the right to be present during any procedure being 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).
I agree to pay as liquidated damages any fines imposed upon me up to the maxima set out in Part 3, Appendix 1.
Where the Parent is not present there must be a Guardian who must produce a written and signed authorisation from the Parent/Guardian to act as their representative.

P/G Declaration (Driver):

I accept this declaration:

Passenger Name:

First

Last

Passenger Address:

Street Address Street Address Line 2 City County Post Code

Passenger Club:

Passenger Motorsport UK Licence Number:

Passenger ACTC Championship Number:

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):

Street Address Street Address Line 2 City County Post Code

I understand that I shall have the right to be present during any procedure being 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).
I agree to pay as liquidated damages any fines imposed upon me up to the maxima set out in Part 3, Appendix 1.
Where the Parent is not present there must be a Guardian who must produce a written and signed authorisation from the Parent/Guardian to act as their representative.

P/G Declaration (Passenger):

I accept this declaration:

Car Make:*

Car Model:

Engine cc:*

Registration Number:*

Year Registered:

Link to Car Regulations if you need to look up information on classes
Don't use the menu at the top or else you will lose all the information you have typed in so far!

Class Entered (please refer to Regs for full details):*

Is a limited slip, torque biasing or locked differential fitted:

ACKNOWLEDGEMENT OF THE RISKS OF MOTORSPORT

I declare that I have been given the opportunity to read the General Regulations of 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 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.

I have read and fully understood the regulations for Control of Drugs and Alcohol as contained in the Competitors’ and
Officials’ Yearbook Regulations H39, D35.1, G15.1.4 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. Further, if I am counter-signing as the Parent or Guardian of a minor then in addition to the deemed consent to the testing of that minor (UK Anti-Doping Rule 5.7.2) I hereby confirm that I give such consent for the minor concerned to be so tested.

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 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.

I have read the above and acknowledge that my participation in motorsport is entirely at my own risk. I agree that I am required to register on arrival by “signing on” at the
designated place before taking part in this event.

Declaration (please tick):*

I Accept

Card Payment Options:*

Car Entry £49

Car Entry and Road Section Insurance by REIS £49 + £24

Paying separately by BACS/Cheque

If paying by BACS or cheque the details can be found in the top menu after submitting and there is no need to fill in any card details below.

Total amount due:

Card Payment

Name on card

If you don't see the submit button please check you have ticked accept to the declaration and completed all fields marked *