Competitors’ Signing-On
Organising Club: The Vintage Sports-Car Club
Permit Nos: 125967
Event Name: VSCC Speed Championship - Round 5 - Prescott Speed Hill Climb
Event Date: 6 & 7 August 2022
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Declaration by all Signatories
I declare that:

1) I have been given the opportunity to read the General Regulations and all Official Documentation and will abide
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 competition and the potential risk inherent with motor sport
and agree to accept that risk. I understand that motor sport 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.

2) To the best of my belief the driver(s) possess(es) the standard of competence necessary for the Event to which
this entry relates and that the vehicle entered conforms to the Regulations of the Event. Where applicable the use
of the vehicle hereby entered will be covered by insurance as required by law.
 
3) I agree that should I at the time of this Event be suffering from any disability whether permanent or temporary
which is likely to affect prejudicially my normal control of the vehicle, I may not take part unless I have declared
such disability to Motorsport UK which has, following such declaration, issued a licence which permits me to do so.
I undertake that at the time of the Event to which this entry relates I shall have passed or am exempt from an ASN
specified medical examination within the specified period. (H10.1.6)

4) If I am the Parent/Guardian/Guarantor of the driver I have countersigned the competitor licence application and
understand that I shall have the right to be present during any procedure being carried out under the Event
Supplementary Regulations and the General Regulations and that I have acquainted myself and the minor with
them, agree to pay any appropriate charges and fees pursuant to those Regulations and agree to be bound by and
submit myself without reserve to the consequences resulting from them (and any alteration thereof). Further, I
agree to pay as liquidated damages any fines imposed upon me up to the maxima set out in Part 3, Appendix 1.
Note: Where the Parent/Guardian/Guarantor will not be present the Parent/Guardian/Guarantor must advise the
organisers in advance, in writing, authorising their appointed representative to so act.

5) I hereby agree to abide by all applicable Motorsport UK Policies and Guidelines including but not exclusively
Safeguarding and Anti Alcohol and Drugs policies and the National Sporting Code of Conduct.

6) I have read and shall respect the regulations for Control of Drugs and Alcohol as contained in the General
Regulations C1.1.7, D35.1, G15.1.4, H38 and have also fully familiarised myself with the information on the web
sites referred to (www.motorsportuk.org, www.ukad.org.uk and www.wada-ama.org) in particular the UK Anti�Doping Rules which have been adopted by Motorsport UK. Further, if I am counter-signing as the parent or
Guardian of a minor then in addition to the deemed consent to the testing of that minor (UK Anti-Doping Rule
5.7.2) I hereby confirm that I give such consent for the minor concerned to be so tested.

7) I understand and agree that my personal data, and that of the persons connected to my entry are being
processed solely for the purposes of running this and will be handled by the organisers in accordance with
Motorsport UK data protection policy: www.motorsportuk.org/data-protection.

Indemnity: In consideration of the acceptance of this entry I agree that neither any one of or any combination of
Motorsport UK and 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 including but not limited to
damage to property, economic loss, consequential loss or financial loss howsoever caused. 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 indemnify and hold harmless each of the Parties in respect of any loss or damage
whatsoever and howsoever arising from my participation in this Event.
I agree to the declaration above. *
Please confirm your car's competition number *
Vehicle/equipment details (please provide Make, Model and (where applicable) Vehicle Passport / Competition Car Logbook Number:) *
(where required) FIA homologation expiry dates:
Fire extinguisher (where fitted), please specify hand held or plumbed in with last service date
Please confirm overalls comply with current acceptable standards FIA 8856-2000 or FIA 1986 Standard *
Required
Please confirm that your crash helmet has a current MSA/Motorsport UK approval sticker
Clear selection
Driver's name *
Driver's contact telephone number *
Please provide your competition licence number *
Please confirm your ASN (usually MSUK) and which Club you are a member of (usually VSCC) *
I confirm the details given above are correct *
Entrant details if applicable - please provide name, ASN, contact telephone number, and Club
I confirm the Entrant details are correct
Clear selection
Please complete the following three questions for under 18s only
Parent/Guardian details if applicable - please provide Licence number and ASN (if applicable) plus name, contact details and Club membership number
I confirm the Parent/Guardian details are correct
Clear selection
Assigned Guarantor (over 18 years) name and contact details
All competitors must complete the following question
Next of kin name and contact telephone number *
Submit
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