ENTRY : Narberth News Year Eve Trial 31st Dec -

Rider Name *

First

Last

Email *

Phone *

Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Date of Birth *

Classes *

Route *

The Sportsman route will be laid out for beginners and novice riders and will be suitable for the TrailBike class. The Sportsman Masters class will ride 5 sections on the blue route and 5 sections on the white route. The Clubman Masters will use the same principle, with 5 sections on the white route and 5 sections on the red route.

Club

AMCA License Number

If held, please enter you classic or modern AMCA license number

Machine Make, Model *

Make and model of machine

Machine Capacity (in cc) *

In cc numbers only

Machine Year *

Year of manufacture

Choose your entry type *

Entry - £20.00

If the event is called off and refunds made, Narberth MCC will retain £1.00 to cover payment charges and admin costs

Total

£0.00

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.

Parent Guardian Signature (for Youth Riders)

Clear Signature

A I have read the entry form and decliarion completed bu the applicant and confirm the answers are true. B I confirm that he/she is competent to take part in the event and that any vehicle which he/she will use is safe and fit for competition. C I will, before allowing him/her to take part satisfy my self that the course and the facilities are safe and will inspect the same. D I also afree that if the applicant should sustain and injust from any cause whilst taking part in the event and as a result bring a claim for compensation against you or the organisers or sponsors or entrants or owners of the venue, I WILL INDEMNIFY AND PAY BACK TO YOU any sum which you may be required to pay back as the result of such a claim.

Credit Card *

Card

Name on Card