walesandwestenduroclub

Events

Wales and west championship 2020/2021

ENTRY DECLARATION T&C

PROPOSED DATES FOR 2021

21ST FEB 2021 CLEARWELL GL16 8QD

THE VENUES ARE SUBJECT TO CHANGE ...

ALL ENTRIES TO BE PAID IN FULL AT TIME OF BOOKING

ENTRY DECLARATION: I/we the undersigned apply to enter the event described above and in consideration thereof:-

I/we further declare that I/we are physically and mentally fit to take part in the event and Iam/we are competent to do so.

I/we confirm that I/we understand the nature and type of event we are entering and its inherent risks and agree to accept the same notwithstanding that such risks may involve negligence on the part of the organisers or officials

I/we confirm that the machine(s) as described below which I/we compete on shall be suitable and proper for the purpose

I/we confirm that if any part of the event takes place on a public highway, the machine(s) described below shall be insured as required by the Road Traffic acts or equivalent legislation and that it/they Will comply with the regulations in respect thereof

I/we agree that I am/we are required to register our arrival by signing on at the designated place not less than 30 minutes prior to commencement of my/our practice or first competition,whichever comes first

ACKNOWLEDGEMENT OF THE RISKS OF MOTORSPORT I/we understand that by taking part in this event I/we are exposed to risk of death,becoming permanently disabled or suffering some other serious injury and I/we acknowledge that even in the event that negligence on the part of the IOPD, the Promoter, the organising club, the venue owner, or any individual carrying out his duties on their behalf were to be a contributory cause of any serious injury I/we may suffer, the dominant cause of any serious injury will always be my/our voluntary decision to take part in a high risk activity

I/we have read the above and acknowledge that my/our participation in motorsport is entirely at my/our own risk

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SUNDAY 21ST FEB 21 CLEARWELL GL16 8QD

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Name: *

Address *

phone no. *

E-mail address: *

Class *

Machine Make *

Model / CC *

Preferred Rider No

membership number

full name to represent online signature ( parent/guardian name if under 18 *

Contact details may be passed to Pentagon Insurance who may contact you to offer competitive insurance quotes . tick box if you do not consent to your details being shared

IOPD LICENCE NO

MESSAGE

Acknowledgement of the ricks of motorsport: I/We understand that by taking part in this event I/we are exposed to a risk of death, becoming permanently disabled or suffering some other serious injury and acknowledge that even in the event that negligence on the part of the IOPD, the promoter, the organising club, the land owner, or any individual carrying out his duties on their behalf were to be contributory cause of any serious injury I/we may suffer, the dominant cause of any serious injury will always be my/our voluntary decision to take part in a high risk activity I/we have read the above and acknowledge that my/our participation in motorsport is entirely at my own risk

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