Offshore Powerboat License Application Form

Powerboat License Application Form

Fill out the form carefully for registration. For those having already entered the CTC or CPC a license fee of only £10pp is required based on 2 persons per boat. Otherwise the full license fee is £150pp. Any 3rd or 4th passenger must pay the full license fee. Unless holding a UIM license from another governing body whereby a £10 admin fee will be required.
Personal Contact Details

This will not be shared
Name*

First NameMiddle NameLast Name
Birth Date*

MonthDayYear
Gender*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
E-mail*
example@example.com
Mobile Number*
Phone Number*
Country of Residence*
License Details*
Have you race before?*

YesNo
Date and Year of last race*
Health Questionnaire Self Declaration of Fitness to Race
I am declaring myself fit to race 2024 race season*

Yes
I am 60 or over*

YesNo
I have proof of having passed a medical*

YesN/A
I don't have proof of passing a medical but declare myself fully fit to race*

Yes
Weight KG & BMI if known*
Blood Group if known*
This would always be checked by medical professionals if necessary
Allergies*

YesNo
My Allergy*
Type of allergy
Anaphylactic Reactions*

YesNoYes & I carry an EpiPen at ALL times
Any cardiac issues or pains*

YesNo
Family history of cardiac problems*

YesNo
Do you suffer from any of the following. Please 'check' box for yes*

High / Low Blood PressureFainting / DizzinessDiabetesHypertensionEpilepsyAsthmaBlood DisordersPeripheral Vascular DiseaseHeart Disease or ArrythmiaThyroid DiseaseRenal DiseasePsychiatric ConditionsMusculoskeletal DisordersHeart Related IllnessDo you have restricted of movement in any limbs or your spine *leave blank if No
If you need visual aid, is your eyesight normal with glasses or other correction?*

YesNoN/A
Any Medications which affect performance / safety * please state*
Do you have a amedical condition past or present, which should debar the you from competitive powerboat racing * please state*
Have you been prescibed any medications in the past 12 months? If YES please list medications below and the reason for taking * please state*
If you suffer from high blood pressure or epilepsy, please state what medication you take * please state*
Have you misused drugs or alcohol in the past 3 years? * please state*
Has you suffered from epilepsy, seizures or any other neurological conditions? * please state*
Is there any reason why the applicant should not participate in powerboat racing? * please state*
Any Comments*
I fully understand that I am declaring myself fit to race in the 2024 season. I also agree that between signing this form digitally by clicking 'yes', if any changes to my health or medication changes, I will inform the Race Secretary of the event and I will be required in any case to sign another declaration on event sign in.*

Yes
DECLARATION a) Neither myself or my team will take any action which brings the UIM, BPRC, BORL or the sport or any other body involved with running the event into disrepute. b) I agree to be bound by the rules of the UIM and the BPRC and the race organisers and will not compete in any unauthorised event using this license. I confirm that my application meets these requirements. c) I understand that it is my responsibility to familiarise myself and for my team to do likewise with each specific Risk Assessment & Advance Programme and/or Race Instructions relating to the events that I compete in and that it is also my own responsibility and that of my team to ensure that the event organiser has adequate insurance cover in place at each event. d) The medical declaration and/or certificate has been completed and signed. e) Identification of Risk I and all members of my team are fully aware and conscious of the actual and potential risks involved in active water sports in general and powerboat racing in particular, including inter alia drowning, hypothermia, physical injuries or death. I and members of my team accept that, by engaging in active water sports/powerboat racing, my physical safety could be endangered. I am also aware that other competitors’ actions, or inactions of the organisers of water sports and powerboat racing events, including the drivers of safety craft, can also endanger my physical safety and that of my crew. f) I and my crew have read and understood the General Racing rules and the class specific rules, to which my license refers, and the International Regulations for Preventing Collisions at Sea and or Lake/Water Authority Officials. I and members of my crew are aware that Harbour & Park Authorities apply bye-laws and regulations and I and members of my crew agree to conform to such bye-laws and regulations when using their waters. I and members of my crew are aware that non-compliance of any of the above rules and regulations could result in BPRC disciplinary action. To the best of my knowledge the information given on this form is correct and complete. g)Acknowledgement of Risk I acknowledge that it is up to me personally to assess whether any event or activity on the water is too difficult for me or my crew. I acknowledge that the safety of my boat and her entire management including insurance is solely my responsibility, and I am satisfied that the boat and crew are adequate to face the conditions that may arise in the course of the race. I acknowledge that scrutineering does not constitute a condition survey of the craft and it is solely my responsibility to decide whether or not to start or to continue in any powerboat race. I acknowledge that the efficiency of the helmets, Neck Restraints & Racing vests worn is solely my responsibility. I have read, understood and agree to abide by the rules set out by the BPRC and UIM where applicable. I also confirm that I have read & understood the Powerboat Racing Charter and Risk Statement. NOTE: THE BPRC and BORL RESERVES THE RIGHT TO REFUSE THE ISSUE OF AND/OR REVOKE AT ANYTIME, A POWERBOAT RACING LICENSE AT ITS DISCRETION*

Yes I agree with this declaration
By ticking 'yes' I confirm that my spouse and dependants are entirely aware of the risks associated with offshore powerboat racing and they entirely agree with my application and my participation in any such events.*

Yes
By ticking 'yes' I agree to save harmless and keep indemnified the Indemnified Parties BORL, BPRC, UIM from and against all actions, claims, costs, expenses and demands in respect of myself, my driver(s), passenger(s), crew, mechanics and support team, boat and equipment (as the case may be) and in respect of loss or damage to property or personal injury sustained howsoever caused arising out of or in connection with my entry in the Event and/or my participating in the Event AND I hereby indemnify the Indemnified Parties in respect thereof absolutely.*

Yes
My Products*
prevnext( X )
Full UK License
£150.00 Quantity



Reduced LicenseRacer having ALREADY entered the CTC/CPC or Racer with UIM sanctioned license (example OCRDA-BPBA-UIM)
£10.00 Quantity



Full UIM License - International add-onIncrease your National license to International
£50.00 Quantity



Total

£0.00
Head & shoulder photograph required*

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Powerboat License Application Form

Personal Contact Details

Health Questionnaire Self Declaration of Fitness to Race