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Est.
2015 MAXXIS TKM FESTIVAL
RACE ENTRY FORM
1959
Held under the general regulation of the MSA Motor Sports Association Ltd (incorporating the provisions of the International Sporting
code of the FIA) and the Supplementary Regulations.
Date of Meeting:
Racing Number:
Name
Transponder Number:
Address
Make of Chassis:
Make of Engine:
Which Club do you belong to:
Comp Licence Number:
Home Phone Number:
HKRC Membership Number:
Work Phone Number:
Parent /Guardian Number:
Email:
Are you a Novice?
FESTIVAL - £90
❑ Yes
❑ No
O PLATE - £95
TRANSPONDER HIRE £10
MY RACING CLASS IS
❑ Honda
❑ TKM Clubman
❑ Junior TKM-Festival
❑ Junior TKM -O Plate
❑ TKM Extreme- Festival
❑ TKM Extreme - O Plate
I have read the supplementary regulations issued for this event and agree to be bound by them and by the General Regulations of the MSA Motor Sports Association Ltd. In consideration
of the acceptance of this entry and of my being permitted to take part in this event, in respect of any parts of the event not held on a publicly adopted road. I agree to save harmless and
keep indemnified by the MSA Motor Sports Association Ltd., such persons or body as may be authorised by the MSA to promote or organise this event and their respective officials, servants,
representatives and agents, from and against all actions, claims, cost, expenses and demands in respect of death of or injury to or damage to the property of myself, my driver(s), passenger(s),
mechanic(s), or associated personnel arising out of or in connection with this entry or my taking part in this event.
MY AGE IS
(If applicable state ‘Over 18 years old’)
I am the Parent / Legal Guardian / Guarantor (delete as appropriate) of the above and understand that I or my Guarantor shall have the right to be present during any procedure being carried out
under the Supplementary Regulations issued for this event and the General Regulations of the MSA. I also understand that it is entirely my responsibility to inform the Stewards / Officials of the
meeting of the age of the drive (if under 18 years old) before such procedure takes place and forfeit any right of appeal against and decision taken without my presence if I do not do so.
When a Guarantor’s representative attends an event with a minor and signs on as the entrant, the representative must produce the Guarantor’s written and signed authorisation to so act.
I declare that to the best of my belief the driver(s) possess(es) the standard of competence necessary for an event of this 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 speed 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 MSA Motor Sports Association Ltd. Who have, following
such declaration, issued a licence which permits me doing so. I undertake that at the time of the event to which this entry relates I shall be in possession of a current valid MSA Medical Certificate.
Signature of Driver_____________________________________
Date________________________________________________
Next of Kin / Guardian_______________________
Address
Signature of Parent / Guardian___________________________
Date________________________________________________
Phone Number:
Phone Number:
Mr/Mrs the parent/guardian of driver under 18yrs
Master/Miss
consent to
taking responsibilty for my child at this MSA kart meeting dated
Parents Signature___________________________________________
Date_____________________________________________________
Temporary
Guardians Signature_________________________________________
Date_____________________________________________________
Closing date for entries is 25th July 2015. If payment does not accompany your entry YOU WILL NOT RACE. Cheques (on line payment and card reader available) should be
made payable to The Hunts Kart Racing Club Ltd. if you would like an acknowledgement you MUST enclose a SAE and send to:
Daphne Freeman, Competition Secretary, 76 Guntons Close, Soham, Ely, Cambs CB7 5DN Tel: 01353 720390 email: [email protected]
Hunts Kart Racing Club Ltd
www.hkrc.co.uk
ENTRIES CANCELLED AFTER THE CLOSING DATE WILL NOT BE REFUNDED OR
CARRIED OVER. NO TELEPHONE ENTRIES WILL BE ACCEPTED.
Incorporated in the UK as a Private Limited
Company No. 1597143 Registered Office: Cox & Co.,
The Granary, High STreet, Turvey, Bedfordshire MK43 8DB
xl0009s
correct at time of printing