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Entry Form

Golden Springs Trial 22nd September 2024

Woolbridge Motor Club Ltd.
Held under the General Regulations of the RAC Motor Sports Association Ltd (incorporating the provisions of the International Sporting Code of the FIA, the supplementary regulations and any written instructions the organising club may issue.
Motorsport UK Permit No. 135989 has been issued
Drivers Details
Name*
First Last
Address*
Address Line 1 Address Line 2 Town/City County Post code Country
Phone*
Mobile
Email*
RTA Driving Licence*
Do you hold a valid Road Traffic Act driving licence?
- Yes
- No
Status*
- Expert
- Novice
Competition Licence Grade and Number*
Minimum RS Clubman
Club*
I am a fully paid up member of
Championships
Please select any championships you are registered for:
- Motorsport UK Championship
- BTRDA Championship
- ASWMC Championship
Emergency contact – driver*
Give name, relationship, and address or phone numbers
Passenger Details (if carried)
Name
First Last
Address
Address Line 1 Town/City Post code
Phone
Mobile
Email
Competition Licence Grade and Number
Club
I am a fully paid up member of
Emergency contact – passenger
Give name, relationship, and address or phone numbers
Vehicle Details
Make of Vehicle*
Model*
Engine Capacity*
Registration No.*
Tyre Make/Size*
Class*
Please refer to the Supplementary Regulations for full details.
Is the car double driven?*
- Yes
- No
Name of other driver
Both drivers of a double-driven car must complete an entry form.
Entry Fee
Entry Fee
- Single entry Woolbridge/Windwhistle
- Single entry Woolbridge/Windwhistle under 18yrs
- Double entry Woolbridge/Windwhistle paying for both
- Double entry Woolbridge/Windwhistle, one driver under 18yrs
- Single entry other clubs
- Single entry other clubs under 18yrs
- Double entry other clubs paying for both
- Double entry other clubs, one driver under 18yrstry o
- Double entry other driver paying
Woolbridge MC Membership: £15.00
Current members check the expiry date on your membership card. You can renew here if necessary
- New
- Renewal
- Not required
Competing / Participating Family Members Quantity
Price: £ 2.50
Total:
£ 0.00
Declaration
I declare that I have been given the opportunity to read the General Regulations of the Motor Sports Association and 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 acknowledge that I understand the nature and type of the competition and the potential risk inherent with motor sport and agree to accept that risk. Further, I understand that all persons having any connection with the promotion and/or the organisation and/or conduct of the event are insured against loss or injury caused through their negligence.
By ticking this box you agree to the above declaration.*
- I Agree
State your age if you are under 18 – Driver
State your age if you are under 18 – Passenger
Parent Guardian
Any indemnity and / or declaration as prescribed above which is signed by a person who has not reached his or her eighteenth birthday shall be countersigned below by that person’s parent or guardian, whose full name and address shall be given. These entries cannot be made electronically at present.
Signed – parent / guardian – Driver
Signed – parent / guardian – Passenger
Address
Address of parent / guardian of Driver
Address
Address of parent / guardian of Passenger