One Event Licence Application

Choose Event Date (within 2 months):*

Name of Event / Organiser:*

Participant's Full Name:*

Address:*

Street Address Street Line 2 (can be blank) City County Post Code

Phone:*

Important: Please ensure email address is typed correctly and with no spaces as we will not receive your application but the payment may still go through.

Email:*

Date of Birth:*

day

/

month

/

year

Name of Parent/Guardian (If under 18):

Declaration:*

I agree to comply with the conditions listed below

Licence Type:*

One Event

Total

Please enter your card number, expiry date and the 3 numbers on the back in the box below.
The name on the card and post code may also be required by your bank.

Stripe

Name on card*

Post Code*

Conditions:
1. It is accepted by the Participant that they knowingly intend to participate in a challenging and risky activity using mechanically propelled vehicles, (referred to as the vehicle) recognised as such under the Road Traffic Act (Off Road) Regulations 1991. The Participant accepts that dangerous conditions plus dangerous, careless and inconsiderate driving plus high speeds plus the use of amateur constructed or modified vehicles may significantly increase the risk of being killed, permanently disabled or seriously injured.
2. The Participant acknowledges that participation in an event of this type entails known and unanticipated risks that could result in physical or emotional injury, paralysis, death or damage to themselves, to property or to third parties. It is understood that such risks simply cannot be eliminated without jeopardizing the essential qualities of this event.
3. The Participant confirms that they possess the standard of competence necessary for the type of event they are entering.
4. The Participant will before participating satisfy themselves of the preparation and condition of their vehicle. That it is suitable, safe and complies with the Regulations.
5. The Participant confirms that their vehicle has no known faults which may lead to a mechanical failure which could cause Third Party damage, injury or death and will use all appropriate Safety Equipment. They accept that a ’head cam’ attachment could compromise their safety in a collision.
6. The Participant will before participating satisfy themselves of the preparation and condition of the course and its facilities and do self-certify that the margins of safety, barriers and braking areas are adequate and suitable for their degree of competence and type of vehicle for the event they have entered.
7. The Participant accepts the responsibility of monitoring all conditions that may materially change the aforementioned and they participate voluntarily and of their own free will in spite of the risks. They know they are free to withdraw at any time without penalty.
8. The Participant certifies that they have adequate insurance to cover damage caused or suffered whilst participating, or agrees to bear the costs of such damage to their vehicle.
9. The Participant accepts that none of the involved parties shall have any liability for injury, death, loss or damage which may be sustained or incurred by the Participant as a result of participation in the Event. They understand that they forgo all rights to compensation from driver/rider to driver/rider liability and Insurance.
10. The Participant agrees to indemnify and hold harmless each of the Parties in respect of any injury, death, loss or damage.
11. The Participant states that they are not taking or have not taken or drunk any substance / medication (prescribed or otherwise) which may affect their ability or judgement in the control of the vehicle.
12. The Participant states that they have no known medical condition or physical disability that would make it unsafe for them to participate or which may be adversely affected by participating.
13. The Participant confirms that should they be aware of any medical condition or injury be it age related or otherwise, prescribed medication or disability which may affect their ability to control or direct the vehicle, they will present themselves to the Chief Medical Officer or Clerk of the Course, prior to signing on for a final appraisal.
14. The Participant accepts that the Organisers may use volunteer marshals in order to keep the costs of participating in this event affordable.
15. The Participant authorises and permits the Organiser (and third parties connected with the event) to administer first aid and to authorise such other medical treatment and transportation as may be recommended by physicians, paramedics and other medical personnel, in the event of illness, accident or injury.
16. The Participant understands that their personal data is being retained solely for the purposes of staging and insuring the event and will be handled by the organisers in accordance with the IOPD data protection policy.
17. The Participant confirms that any information given is correct to the best of their knowledge and any changes will be notified to the organisers.
18. The Participant has read the rules and regulations governing the event along with any briefings or notices on the day.
19. This licence will be revoked immediately upon failure of the Participant to observe all or any of the conditions stated herein.