2018 MEMBERSHIP AND RACE ENTRY FORM

Transcription

1 2018 MEMBERSHIP AND RACE ENTRY FORM Please note the Series minimum Licence requirements for 2018 are: Championship FIA International Grade C or C/H; FIA Masters Historic Sports Car Championship FIA International Grade C or C/H; MSA National A or ASN equivalent with the exception of Nurburgring where Competitors must have an International Licence; Pre-66 Touring MSA National B (in the UK) or MSA National A (in Europe) or ASN equivalent. SECTION ONE - MAIN COMPETITOR DETAILS AND MEMBERSHIP Surname: First Name: Address: Date of Birth: Nationality: Telephone: Fax: Licence Number: Licence Grade: Country Licence Issued: Emergency Contact Name: Emergency Contact No: Country: MAIN COMPETITOR 2018 MEMBERSHIP Full Membership Pre-66 Touring Car Full Membership Single Event Membership* 475 inc VAT 325 inc VAT 175 inc VAT (Per Event) SECTION TWO - CO-DRIVER DETAILS AND MEMBERSHIP (if applicable) All Co-Drivers must complete a Membership Form. If your Co-Driver will change during the season, please ensure that you inform the Masters Office at least 14 days prior to the event by submitting a signed & completed Membership form. Surname: Address: First Name: Date of Birth: Nationality: Telephone: Fax: Licence Number: Country Licence Issued: Emergency Contact Name: Licence Grade: Emergency Contact No: Country: CO-DRIVER 2018 MEMBERSHIP Full Membership Pre-66 Touring Car Full Membership Single Event Membership* 475 inc VAT 325 inc VAT 175 inc VAT (Per Event) *Covers a driver for a single meeting. A maximum of two Single Event Memberships can be used per year. Single Membership does now entitle a driver to score championship points, if relevant to that series. Please indicate if the Co-Driver will be paying their own Membership fee in a separate transaction. If this is the case, please complete a separate payment section (Section Five).

2 SECTION THREE CAR DETAILS Entries will not be confirmed unless we have a FULL copy of the current FIA HTP papers for all cars entered. CAR 1 CAR 2 CAR 3 CAR 4

3 SECTION FOUR RACE ENTRIES ENTRIES CANNOT BE ACCEPTED WITHIN 7 DAYS OF AN EVENT Please use the Tick to Enter box to enter a race. If you have more than one car listed above in Section 3, please use the number reference for each car in the Car box. Your signed declaration will cover you for all Events and Races and should your Race Entries change through the year there will no need to re-complete this form. Date Venue/Event Races Available April May June July 6-8 July August Imola Motor Legend Festival Brands Hatch GP Masters Historic Festival Most, Czech Republic The Most Historic Grand Prix (free hotel room included see note 1 below) Silverstone Support Race to Formula 1 Rolex British Grand Prix Silverstone Silverstone Classic Nürburgring Oldtimer GP Masters Historic Formula One 2 International Trophy for Classic GT Cars () 3 Transatlantic Trophy for 4 Race Format Q:1x35 Q:1x35 Q:1x20 R:2x20 Q:1x27 R:1x50 Q:1x27 R:1x50 Q:1x27 R:1x45 R:1x65 Entry Fee 2250 Tick to Enter Car

4 Date Venue/Event Races Available August/ September 31-2 September October Zandvoort Historic Grand Prix Spa Francorchamps Spa Six Hours Dijon Dijon Motors Cup Race Format FP:1x20 Q:1x35 Entry Fee Tick to Enter Car Key: All entry fees shown above are inclusive of VAT FP = Free Practice - Q = Qualifying Session - R = Race Duration All durations are correct at time of going to print but may be subject to change Notes: 1. Most Hotel Rooms - Competitors will receive one Hotel Room per entry, extra rooms are bookable but will be charged by the Hotels directly. 2. The Support Race for Historic Formula One cars at the British Grand Prix is a non-championship round 3. International Trophy for Classic GT Cars () at Silverstone requesting an entry into this race does not guarantee an entry. Entries are solely at the discretion of The Silverstone Classic Selection Committee. Entries for this race close on Friday 1 st June Confirmation of entries will be ed after this date. 4. To race in the at the Oldtimer Grand Prix you must have a minimum of an International D Licence.

5 SECTION FIVE MEMBERSHIP PAYMENT FORM Entry Cancellation Policy To receive a full refund of an entry fee, notice must be made in writing to the Masters Office at least 14 calendar days prior to the start of the event to which the entry fee applies. We accept three methods of payment: 1. Cheques Please make cheques made payable to Masters Historic Racing Ltd. 2. Credit Card Please complete the payment details below (Please note there is a 2% charge on all credit card payments) I wish to pay by Visa / MasterCard / Amex / Debit Card Card Number: Card Expiry Date: Start Date: Security Code: Name on card: Address where card is registered: 3. Direct Bank Transfers These can be made to the account details below. Please ensure your name is CLEARLY shown in any transfer. Account Name: Masters Historic Racing Ltd Bank Name: Arbuthnot Latham, London IBAN: GB68ARBU BIC: ARBUGB2L Account No: Sort Code: Payment Total: Main Driver Membership (payable in full upon application) Co-Driver 1 Membership (payable in full upon application) Co-Driver 2 Membership (payable in full upon application) Race Entry Fees I wish to pay my entry fees by event (the first event will be charged along with Membership fees upon receipt of this form by Masters Historic Racing, all other event fees will be charged four to six weeks prior to each event) I wish to pay my entry fees in full for the year Race Entry Total Total Amount Due

6 SECTION SIX MEMBERSHIP DECLARATION FORM DECLARATIONS, UNDERTAKINGS AND UNDERSTANDINGS BY PARTICIPATING MAIN COMPETITORS/CO-DRIVERS FOR ALL RACE SERIES IN 2018 Note: Prior to taking part in any race series organised by Masters Historic Racing Ltd (MHR) in 2018, all Main Competitors/Co- Drivers are required to sign this declaration form. By signing this declaration form Main Competitors/Co-Drivers acknowledge having understood that this form covers all race series taking place in 2018 and is valid for the entire season once it has been signed. The Main Competitors/Co-Drivers agree to perform and abide by the following terms and conditions: A) Declarations and Understandings 1. I declare that I have taken the opportunity to read and understand the relevant Masters, FIA, Motor Sports Association and all other applicable rules and regulations. 2. I understand that I am participating in the race series on a voluntary basis and at my own risk. I understand and acknowledge that participation in motor sport carries an inherent risk and the ultimate responsibility for safety lies with the individual; competitors & co-drivers are required to ensure their own safety and that of fellow participants at all times. 3. At all times prior to and during events (including practice sessions) the conditions of general safety set by the FIA International Sporting Code and its Appendices, together with any additional requirements set by individual ASNs of the host country publicised in the event Supplementary Regulations must be complied with. 4. As owner of the entered car as recorded in the car HTP papers, I consent to the participation of the car in accordance with the terms and conditions of entry and participation, in particular as regards indemnity and waiver of my rights, as specified on the Race Entry Form, and all other applicable rules and regulations. B) Confirmation of state of health/ car eligibility 5. I confirm that I have no serious health issues or problems that may affect my participation in the race series. I am physically and mentally fit and competent to take part in the events; should that position change during the 2018 racing season I undertake to notify MHR and/or refrain from participation in the race series. 6. The car entered and described in this application meets both the letter and spirit of the FIA and MHR technical and sporting rules and regulations (which the undersigned acknowledges having read and understood) currently in force for the Class in which it is entered; the employees, agents and associates of the owner, Main Competitors/Co-Drivers undertake to be bound by and comply with all applicable rules, regulations and decisions. 7. All Main Competitors/Co-Drivers acknowledge having effected an appropriate policy of insurance against all liability which may be incurred for any damage, loss, costs, expenses or injury to any person or property which may arise from their attendance and/or participation in any Masters event. No reliance is placed on any insurance put in place by the organisers. C) Release and Indemnification 8. I certify and represent to MHR that I agree and comply with the above clauses and that, where applicable by law, such clauses take precedence over the Laws or Regulations of any Country of the EU or any other Country in which an event or events take place. 9. This agreement shall be governed, construed and enforced in accordance with the laws of England and Wales. Save to the extent that FIA has jurisdiction, any dispute arising out of or in connection with this contract, including any question regarding its existence, validity or termination, shall be referred to and finally resolved by arbitration under the London Court of International Arbitration (LCIA) Rules, which Rules are deemed to be incorporated by reference into this clause. The number of arbitrators shall be one; the seat of the arbitration shall be London with the English language as the language of proceedings. I AGREE THAT I HAVE READ AND FULLY UNDERSTOOD THIS DECLARATION FORM PRIOR TO SIGNING IT. Main Competitor Signature: Co-Driver Signature: Date: Date: Masters Historic Racing Ltd The Bunker, Lower End Road, Wavendon, Milton Keynes, UK. MK17 8DA T: F: E: Team@MastersHistoricRacing.com