Anglesey Aggregates Palferman Road Rally 2023 - Officials' Signing-On

Organising Club:

Caernarvonshire & Anglesey Motor Club Ltd

Permit No(s):

132205

Event Name:

Anglesey Aggregates Palferman Road Rally 2023

Event Date:

2023-09-16

UNDERTAKING

ALL PERSONS APPOINTED TO ACT IN AN OFFICIAL CAPACITY AT THE MEETING MUST SIGN BELOW. Written agreement of a parent or guardian must also be obtained in respect of Officials under 18 years of age.

I agree to act in official capacity at this meeting and in consideration of this the organising club(s) have effected for my benefit a Personal Accident Insurance Policy for death or benefits as prescribed more specifically by Motorsport UK. I have been given an opportunity to read the General Regulations of Motorsport UK and, if any, the Supplementary Regulations for this event and agree to be bound by them. I declare that I am physically and mentally fit to carry out my duties and that I will inform the organisers immediately should any change in my condition occur which I have reason or ought to have reason to believe would affect my ability to carry out my duties. I acknowledge that I understand the nature and type of competition and that as an official, I may be exposed to the potential risk inherent in motor sport and I will undertake my duties with their associated risks with due and proper regard for my safety and that of others. Further, I understand that all persons having any connection with the promotion and/or organisation and/or conduct of the event are insured against loss or injury caused through negligence. I declare that I am not suffering from any infirmity or physical disability likely to affect the performance of my duties as an official of the event.

I understand and agree that my personal data is being processed solely for the purposes of running this Event, and will be handled by the organisers in accordance with Motorsport UK data protection policy: www.motorsportuk.org/data-protection.

I hereby agree to abide by all applicable Motorsport UK Policies and Guidelines including but not exclusively Safeguarding and Anti Alcohol and Drugs policies and the National Sporting Code of Conduct.

MEDICAL PRACTITIONERS. All doctors attending motor sport meetings as medical officers must be fully registered with the General Medical Council, must be members of a recognised medical defence organisation and be covered for work outside a hospital. Doctors must be competent in the field in which they are working and must be aware that they are expected to provide themselves with such equipment as they deem necessary for the proper performance of their duties (G15.1).

Emergency Contact: (Required by Police Authority in case of serious accident)

Last Updated: 01 March 2022