CHOLMONDELEY POWER AND SPEED
10th - 12th JUNE 2016
OFFICIAL ENTRY FORM FOR ALL COMPETING VEHICLES
Organisers:
British Automobile Racing Club
Thruxton Circuit, Andover, SP11 8PN
Promoter / Reply to:
CPOP Ltd., 4 Castle Farm
Cholmondeley, Cheshire, SY14 8AQ
This event is held under the General Regulations of the Motor Sports Association, (incorporating the provisions of the International Sporting
Code of the FiA) together with the Supplementary regulations and any further instructions issued by the organisers. Final instructions will be
issued with competitors passes approximately three weeks prior to the event.
Title
Forename
Surname
Vehicle Owner / Entrant:
Telephone (Private/Business)
Address:
Telephone (Mobile)
Telephone (Fax)
Post Code:
Email address
Title
Forename
Surname
Proposed Driver / Rider:
Telephone (Private/Business)
Address:
Telephone (Mobile)
Email address
Post Code:
Licence
(Only needed if
doing timed runs)
Type:
Speed / Race / Rally /
Grade:
Int. . . . / Nat. A / Nat. B /
ASN:
MSA / Other
Number: Details of the Vehicle
Year
Make
Model
Chassis Number
Engine Make
Engine Capacity (cc)
Car Colour(s)
Permanent Number *
Has this vehicle / motorcycle appeared at CPOP before, if so in which year(s)?
* While every effort will be made to allocate a competition number to your vehicle which corresponds to any permanent number that may have already been painted upon it and is
given above, the organisers reserve the right to renumber vehicles at their discretion. All allocated numbers must be clearly visible to the timekeepers.
Please enter below full details of the person to be notified in the event of a serious incident
Name:
Address:
Relationship to driver
Telephone (Private)
Telephone (Mobile)
Post Code:
Owners are also asked to provide the following items prior to the event:
Enclosed
1.
A commentators sheet containing 5 or 6 quick reference statements about the vehicle
2.
A commentators sheet containing 5 or 6 quick reference statements about the driver / rider
3.
A photograph of the vehicle as it will appear at Cholmondeley (at least 300 dpi)
4.
If the vehicle has any Identity Forms then please also provide a copy of the front page
Received
The closing date for the receipt of fully completed entry forms is midday on Friday 27th May 2016, however any entries received after this point
may be accepted at the discretion of the organisers and under whatever terms they see fit.
Upon arrival at the event you will obliged to read and sign the following declaration before being permitted to take part in the Cholmondeley
Power and Speed, family motorsport festival.
“I declare that I have been given an 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 understand that motorsport is 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 my entry I agree that neither any one of or any combination of the MSA and its associated clubs, the
organisers, the track owner or other occupiers, the promoters and their representative officers, servants, representative and (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. 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 and hold harmless each of the Parties in respect of any loss or damage whatsoever and howsoever arising
from my participation in the 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 understood
the Procedure for Control of Drug and Alcohol as contained in the Competitors and Officials Yearbook and I have familiarised myself with the information on various website in
particular the UK Anti-Doping Rules which have been adopted by the MSA. I hereby agree to abide by the MSA Child Protection Policy and Guidelines.
If I am the Parent/Guardian/Guarantor of the driver 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 the MSA. As the Parent/Guardian/Guarantor I confirm that I have acquainted myself with the MSA 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. In addition to the deemed consent to the testing of that minor I hereby confirm
that I give such consent for the minor concerned to be so tested.
I hereby agree to abide by the BARC Child Protection Policy and Guidelines and I give permission for details of any injuries I may suffer during the event to be given to the Clerk
of the Course.”
The driver must read the seven points below before printing their name and signing the appropriate box to signify his / her acceptance of the
terms and conditions as stated.
In consideration of being allowed to take part in this event I declare and agree that:
1. The information in this entry form and my acceptance of the terms of my competition licence are correct
2. I understand the nature of the competition I am entering and I am competent and both physically and mentally fit to take part
3. Any vehicle I use will comply with the regulations applicable to the event and will be safe and fit for use in the competition
4. Before taking part in the event I will ensure that I have inspected the course, 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 own ability or the safety of the venue or any vehicle I may drive
6. I accept that competition in motor sport may involve the risk of injury or death and I agree to take part with that knowledge at my own risk
7. Before taking part in the event I will read and be bound by and comply with any general or supplementary regulations and any final instructions issued by the organisers of the
event and the venue owners.
English: I have read and understand the contents of this entry form and the declaration and agreement and have contacted the CPOP office
for explanations or translations where necessary
French: J’ai lu et je comprends le contenu de cette fiche d’engagement ainsi que la section déclaration et acceptation et je prends contact
avec l’office CPOP pour obtenir éclaircissements ou traductions.
German: Ich bestatige hiermit, dass ich die anweisungen dieses nennungsformulares, sowie die einverstandniserklarung und weiteren
angaben gelesen und verstanden habe. Im zweielsfalle habe ich CPOP Buro um erklarungen oder ubersetzung ersucht.
Print drivers name:
Drivers signature:
Date Signed:
Entry received on:
If a competitor has yet to reach their 18th birthday then this entry form must be countersigned below and the parent / guardian / guarantor must
also countersign all official documentation at the event including sign-on sheets.
Parent / guardian / guarantor name (Printed):
Parent / guardian / guarantor signature: