Dukeries Track Day 2018 Internet Entry Form

Entries to this event are now closed and this page is for record only

 

Entries finally close Friday 5th January 2018

Entries: Joanne Smith & Andy Smith

12 Breckbank Forest Town Mansfield Notts

Telephone 01623 480410 or 07803590446 (Evenings after 7.00pm and before 9.00pm only)

e-mail: membership@dukeries-motorclub.co.uk

 The Dukeries MC Track Day

at Blyton Park

Sunday 7th January 2018

Online Entry system.

Please follow the steps below to enter the Track Day.

  1. Complete all the fields in the form below. The fields with red backgrounds are mandatory and must be filled in otherwise you will not be able to continue.
  2. Once you have hit the "Enter the Track Day" button at the end you will receive an automated response confirming we have received your entry form.
  3. There are THREE ways to pay

Within 48 hours of us receiving the payment for your entry you should receive an e-mail confirming acceptance of your entry from the Entries Team..

If you don't receive a response within 3 days of the expected payment date, or if you have any other questions,please e-mail:.  membership@dukeries-motorclub.co.uk

Please put TBC in any red field which you do not know the details for.

Document Addressing
E-Mail address for communication
Real Name of this person
Driver
Full Name
Address
Post Code
Contact Telephone Number
E-Mail Address
Club
Additional Driver
Full Name
Address
Post Code
Contact Telephone Number
E-Mail Address
Club
Car
Make
Model
Colour
Registration Number
Engine Capacity
Person to be contacted in case of serious accident to Driver
Name
Address
Post Code
Telephone Number
Relationship
Will this person be attending the event?
Person to be contacted in case of serious accident to Additional Driver
Name
Address
Post Code
Telephone Number
Relationship
Will this person be attending the event?
Fees - see above for how to pay
Entry Fee £60 - (£63 if PayPal use the drop down to select) £
Dukeries MC Membership till 31/12/2018 £
Additional Driver£
Total Money to be sent£
Payment Method and Details

The details on this form will be held on computer in order to be used for the administration of this event. They will also be used to send you information about future events organised by this club, unless you untick this box to indicate you do not wish to receive information on further events.
The details on this form may also be passed on to other motorsport organisations, unless you untick this box to indicate you do not wish these details passed on.

Remember your entry is subject to receipt of the correct entry fee. An automated acknowledgement is NOT confirmation of entry.

Reserve entries will be informed by e-mail to the address(es) given above.

By clicking on the "Enter the Track Day" button below you agree and comply with the following:

CARS

Any competition car with a current MSA Rally Car logbook or a currently registered road going car (no open cars), which must have a current MOT (if required).  This documentation must be provided at drivers signing-on to comply with the Insurance requirements.

Cars must be fitted with secure seats / seat belts for the driver and front seat passenger. Cars that do not match these requirements will not be allowed to start.   

DRIVERS

All drivers must be at least 17 years of age and possess a full RTA driving licence. They must be Signed-On and be identified by a Red wristband.

Drivers must wear a securely fastened seat belt and an appropriate crash helmet at all times when on the track.

You are only allowed to take one passenger at a time and they must be in the front seat and wearing a securely fastened seat belt and an appropriate crash helmet.

Passengers must also sign on before a wrist bans will be issued.

Wrist bands must be shown to the start marshals.

No one under the age of 14 years will be allowed to participate - Should a child be considered to be too small to be safely secured in a vehicle then the organisers reserve the right to prevent participation.

I declare that I am physically and mentally fit and competent to take part in the event. I understand that motorsport is dangerous and accidents causing death, injury, disability and property damage can and do happen. I understand that these risks may give rise to my suffering personal injury or other loss and I acknowledge and accept these risks.

‘In consideration of the acceptance of this entry I agree that neither any one of or any combination of Dukeries Motor Club, the organisers, the track owners or other occupiers, the promoters and their respective officers, servants, representatives and agents (the “Parties”) shall have any liability for loss or damage which may be sustained or incurred by me as a result of participation in the Event.

Nothing in this clause is intended to or shall be deemed to exclude or limit liability for death or personal injury.

To the fullest extent permitted by law I agree to indemnify and hold harmless each of the Parties in respect of any loss or damage whatsoever and howsoever arising from my participation in the Event.

'I declare that to the best of my belief the driver(s) possess(es) the standard of competence necessary for an event of the type to which this entry relates and that the vehicle entered is suitable and roadworthy for the event having regard to the course and the speeds which will be reached'.

 ‘I understand that should I at the time of this event be suffering from any disability whether permanent or temporary which is likely to affect prejudicially my normal control of my vehicle, I may not take part unless I have declared such disability to the organisers and this has been approved by the venue owners and the event insurers.

Any drivers who drive in a manner that could be deemed dangerous or inappropriate for the event will be be asked to cease such behaviour and if they do not they will NOT be allowed to continue to take part. The standards will be policed by the start marshals, track side marshals and the event organisers.

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