Clerk of Course Determination

Clerk of Course Determination
Promoter
Meeting Name
Venue
Date

DayMonthYear
Date
Permit Number
To (Name of competitor/ entrant)
From (Name of Clerk of Course)
The following determination is made on:
Date

DayMonthYear
Date
Time

Hour Minutes

AM/PM Option
Determination must state as a minimum, the rule breached, the evidence provided to confirm the breach and penalty imposed:
Evidence

Cancelof
Details of Clerk of Course
Name
MA licence Number:
Accreditation
Licence Expiry

DayMonthYear
Date
Signature

Clear
In accordance with the current Manual of Motorcycle Sport, you may have the right to protest this determination. Should you wish to exercise this right, you should consult the Manual for the correct procedure.
Should be Empty: