NCORTC RS CLUBMAN - COMPETITOR’S SIGNING-ON

NCORTC RS CLUBMAN - COMPETITOR’S SIGNING-ON
Event: Haggate Date: 19/10/2025 Permit Number - 202929
Declaration

I declare that I have been given the opportunity to read the NCR and if any the Official Documents for this Event and agree to be bound by them. I declare that I am physically and mentally fit to take part in the Event and I am competent to do so. I acknowledge that I understand the nature and type of the Competition and the potential risk inherent with motor sport and agree to accept that risk.

I understand that motorsport can be dangerous and accidents causing death, injury, disability and property damage can and do happen. I understand that these risks may give rise to my suffering personal injury or other loss and I acknowledge and accept these risks.

In consideration of the acceptance of this Entry I agree that neither any one of or any combination of the ASN and / or its associated Clubs, the Organisers, the Track owners or other occupiers, the promoters and their respective, officers, servants, representatives and agents (the “Parties”) shall have any liability for loss or damage which may be sustained or incurred by me as a result of participation in the Event such as damage to property, economic loss,
consequential loss, reputational loss or financial loss howsoever caused (‘Losses’). Nothing in this clause is intended to or shall be deemed to exclude or limit liability for death or personal injury. To the fullest extent permitted by law I
agree to hold harmless each of the Parties in respect of any Losses whatsoever and howsoever arising from my participation in the Event. Further I agree to accept responsibility for and where necessary compensate the Parties in respect of any Losses arising or howsoever caused by my negligence or actions where they are determined to be in breach of the Motorsport UK National Competition Rules as they apply to my participation in the Event.”

I declare that to the best of my belief the Driver(s) possess(es) the standard of competence necessary for an Event of the 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 speeds which will be re
Vehicle Details:*

Class 1 (50" but not exceeding 87")Class 2 ( over 87")Class 3 (modified)RTV (Road Taxed vehicles)Novice
Driver Details:*

First NameLast Name
Age*
Phone Number*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Club Name*
Club Membership Number *
MSUK licence Number*
Photo of MSUK Licence & Club Membership Card*

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Cancelof
Drivers Signature*

Clear
Number of Entrants (Drivers)*

SingleDoubleTriple
Name of Second Driver

First NameLast Name
Name of Third Driver

First NameLast Name
Navigator Details:

First NameLast Name
Age
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Club Name
Club Membership Number
MSUK licence Number
Photo of MSUK Licence & Club Membership Card

Browse Files

Cancelof
Signature

Clear
Assigned Parent/Guardian Details (over 18 years):

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Signature

Clear
Next Of Kin Details :*

First NameLast Name
Phone Number*
Next of Kin Address *

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
The clubs bank details are as follows: Account Name – NCORTC Sort Code – 05-06-81 Account Number - 33578674 Please send payment through after you have filled in this form.

Payments for early bird discount of £30 ends 15/10/2025 at11pm After cut off and on day payment of £35

Memberships - £10 for competitor and £10 for co-driver

Thankyou
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