EVENT APPLICATION FORM

Navigation Rally

EVENT ………………………………………… DATE ……………………………

ALL EVENTS

Held under the General of the Motor Sports Association Ltd., (incorporating the provisions of the International Sporting Code of the F.I.A.).

“I have read the supplementary regulations issued for this event and agree to be bound by them and by the General Regulations of the Motor Sports Association Ltd. In consideration of the acceptance of this entry or of my being permitted to take part in this event, I agree to save harmless and keep indemnified the Motor Sports Association Ltd., such person, persons or body as may be authorised by the Motor Sports Association Ltd., to promote or organise this event and their respective officials, servants, representatives and agents from and against all actions, claims, costs, expenses and demands in respect of death or injury to myself, howsoever caused, arising out of or in connection with this entry or my taking part in this event, 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”.

Furthermore in respect of any parts of this event on ground where third party insurance “is not required by law” this agreement shall, in addition to the parties named above extend to all and any other competitor/s and their servants and agents and to all actions, claims, costs, expenses and demands in respect of any loss or damage to the person or property or myself, my passenger, or mechanic but shall extend to a competitor adjudged guilty of reckless driving under the said General Regulations.

“My age is …………………………….. (if applicable state ‘over 18 years’)

Drivers Address ………………………………………………………………………………………………………….

Competition Licence No. …………………         Club ……………………..

Make of Car ………………………… Model …………………………… Capacity ………………… cc

Registration No. …………………….

Membership no……….: