MORINI RIDERS CLUB

ENTRY FORM - TO BE COMPLETED BY ALL RIDERS

I wish to enter the “A Tutto Gas practice day" to be held at Cadwell Park on Thursday 24th July 2008

MRC membership number OR

Other Club name membership number

Full Name Phone number

Address 1
Address 2
Address 3

Person to contact in case of accident :

Full Name Phone number

Address 1
Address 2
Address 3

Do you hold a racing licence?	If YES, please will you agree to help with sighting laps	Have you been to Cadwell before?
Yes No	N/A Yes No	Yes No

Have you been on a track day before?	Which group would you like to be in? (Make-up of the groups will be at the discretion of the organisers on the day)
Yes No	Morini Moderate Rapid

Machine details:

1st - Make Model Engine size(cc)


2nd -Make Model Engine size(cc)

A TUTTO GAS PRACTICE DAY

Held under regulations issued by the Morini Riders Club, in accordance with the operators of the Cadwell Park circuit.  Final instructions to be issued.

Please note:
This indemnification must be signed by all riders, no per pro signatures will be accepted.

INDEMNIFICATION
I certify that all personal and machine details supplied by me are correct. I have read the regulations issued for this practice day and agree to be bound by them.

In consideration of this my entry, I agree to save harmless and keep indemnified the Morini Riders Club, the owners or lessees of any land used for this practice day and their respective officials, servants, representatives and agents, other riders from and against all actions, costs, expenses and demands in respect of death, injury, loss or damage to the person or property of myself or my mechanics or helpers (as the case may be) howsoever caused arising out of or in connection with my entry or taking part in this practice day and notwithstanding that the same may have been contributed to or occasioned by the negligence of the said bodies, their officials, servants, representatives or agents.

I declare that to the best of my knowledge and belief that I possess the standard of competence necessary for an event of this type and that the machine entered is suitable and roadworthy for this event having regard to the course and speeds which will be reached.

I enclose my fee of : £100 £110 £120

I declare that I am over 18 years of age.

Rider’s Signature:

Date:

Date of Birth: