APPLICATION FOR MEDIA ACCREDITATION TO THE SILVERSTONE ROUND OF THE DUNLOP MSA BRITISH TOURING CAR CHAMPIONSHIP – 26/27 SEPTEMBER 2015 IMPORTANT: Please read the sections below carefully before completing this application form. Forms not fully completed will be disregarded. Please note that the completion and submission of this form does not guarantee the granting of a Media Pass. All applications MUST be supported by the following: Please check box 1) 2) 3) 4) A letter of accreditation from an editor of a recognised publication / agency / media organisation. At least three examples of work relevant to motorsport events published in the 2014 / 2015 season by a recognised publication / agency / media organization. The applicant must be clearly credited. Photographers must provide proof of public liability insurance cover - minimum £5M. Websites/electronic media will be accredited at the discretion of Silverstone Circuits Limited. A rights fee may be charged. Only sites which are regularly maintained and contain editorial content relevant to the Championship will be considered. Coverage from the championship in the previous season must be provided. Please note that websites/electronic media will be accredited at the discretion of Silverstone Circuits Limited. The origin of photos used on the site must be clearly shown. The allocation of a pass does not permit the sale of images for commercial purposes – for media use only. Further documentation, including analytics reports, may be requested. Enclosed Enclosed Enclosed Please note that without the above supporting documentation, the application will NOT be considered. ALL APPLICATIONS MUST BE RECEIVED BY 12.00HRS, FRIDAY 18 SEPTEMBER 2015. APPLICATIONS RECEIVED AFTER THIS DEADLINE WILL NOT BE CONSIDERED. Please complete in block capitals: Name:............................................................................ For whom will you be working principally? Address: ....................................................................... ....................................................................................... ....................................................................................... ....................................................................................... ....................................................................................... ....................................................................................... .....................Post Code:………………………………… Name of editor / director: Home Tel: ...................................................................... ....................................................................................... Mobile: …………………………………………………..... Tel: .........................................................………………. Email: .........................................................……………. Email: .........................................................……………. I will be working primarily as: Print Journalist Radio Journalist Photographer Website Journalist Signature of applicant: ........................................................................... Once completed, please return this form with supporting documentation listed above to: Carol Watts, Press Officer, Silverstone Circuits Limited, Silverstone, Northamptonshire, NN12 8TN Fax: 01327 323265 or Email: [email protected] SILVERSTONE CIRCUITS LTD - 2015 EVENT MEDIA PASS INDEMNITY AND ACKNOWLEDGEMENTS In accepting any pass which enables me to move outside the approved enclosures at this event, I acknowledge the risks to myself in the use of this pass and accept that motorsport can be dangerous and that accidents can, and do, occur despite organisers taking all reasonable precautions. Furthermore, in consideration of the facilities granted to me, for which the pass is issued, I agree, unless the law provides otherwise, to save harmless and keep indemnified the organisers and promoters of the event for which the pass is issued, including but not limited to Silverstone Circuits Ltd, British Motorsport Promoters Limited, the Motor Sports Association Limited or the Motorcycle Circuit Racing Control Board (as the case may be) and their respective officials, servants, representatives and agents and drivers from and against all actions, claims, costs, expenses and demands in respect of death, injury, loss of or damage to any persons, or their property, arising from my actions whilst at Silverstone Circuit, notwithstanding that the same may have been contributed to or occasioned by the negligence of the said bodies, their officials, servants, representatives and agents and drivers or riders and passengers. I agree to comply with any terms and conditions applying from time to time to admittance to the Venue and to the instructions of officials, failing which, I acknowledge that Silverstone Circuits Ltd has the absolute right to remove me from any of the Venue and/or to remove my pass. I declare that I am over 18 years of age. I also declare that I am not suffering from any infirmity or physical disability likely to affect my mobility. Name: …………………………………………………… Signed: …………………………………………………. Date: …………………………….