Mid Wales : Round 6 Welsh Championship -

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16th July 2023 at Abbeycwmhir.

Please note this is a Welsh Championship Event. A minimum of 10 sidecar entries are needed to run the class

Rider Name *

First

Last

Passenger Name (if applicable)

First

Last

For sidecar passengers only

Email *

Phone *

Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Home Town/Location *

For the programme

Date of Birth *

Riding Number *

AMCA or Welsh Championship Riding Number

AMCA License Number *

AMCA Classic or Modern License Number; enter 0 if no license held and day license required.

AMCA Club

Class

Machine Make, Model *

Make and model of machine

Machine Year *

Year of manufacture

Machine Capacity (in cc) *

In cc numbers only

Additional Class

Pre68 wil be combined with Pre65 or Pre74 depending on entry numbers

Machine Make, Model #2

Make and model of machine

Machine Year #2

Year of manufacture

Machine Capacity (in cc) #2

In cc numbers only

Choose your entry type *

Solo - £46.00
Sidecar - £56.00

(£1 of the entry covers card charges and is non-refundable; cheaper than two 1st class stamps)

Do you need a day license ?

Day License - £10.00
Day License Passenger - £10.00

Select the items you need; if you don't have an AMCA license you need to select a day licence. Licenses will be checked at the event.

LATE ENTRY FEE *

Price: £10.00

Signature

Clear Signature

Declaration: Motor racing can be dangerous and may involve serious injury or death. You must read and agree to the following declaration which is designed to create a legally binding relationship in order for you to enter and compete. I confirm that the machine (s) entered by me comply with AMCA Classic Rules. 1. I confirm that the information in this entry form and the information and my acceptance of the terms of my licence are correct. 2. I confirm that I understand the nature of the competition and I am competent to take part 3. I confirm that the vehicles I use will comply with the regulations and will be safe and fit for use in competition. 4. Before taking part in the event I will ensure (unless prohibited) that I have inspected the venue, track and the facilities and geographical features and that I am satisfied that it is safe 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 completion in motor sport may involve the risk of injury or death and I agree to take part at my own risk 7. Before taking part in the event I read and be bound by and comply with general regulations and my supplemental and final instructions issued by the AMCA, the organisers, 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 organisers and seek approval before taking part.

Total

£0.00

Stripe Credit Card *

Card

Name on Card

Name