Athea Motorcycle Racing Co. Ltd.
Athea, Co Limerick, Ireland

ENTRY FORM 2009

(Download the Form in the "Downloads" Section and Print)

Saturday 27th June & Sunday 28th June 2009

Held under the G.C.R. & Standing Regulations of the F.I.M. & the M.C.U.I. & the M.C.U.I. (Southern Centre) Ltd

M.C.U.I. Permit No: 09/060/RR - 2009 Entry Form - Closing Date: 14th June 2009

Details Required – Driver (Please Print)

Riders Name ______________________________________________________________________________

Full Address _______________________________________________________________________________

__________________________________________________________________________________________

Age_________ Blood Group ________ Club ___________________________________________

Telephone No.(Including Code) _____________________ Email Address ___________________________

Competition License No. _________________ Governing Body by whom issued ___________________________

Previous Experience / No. of Years ____________________________________________________________

Transponder Number

ENTRY FEE € 75 / £70 Stg Per Race up to a Maximum of €180 / £170 Stg
Cheques/Postal Orders Made Payable to: Athea Motorcycle Racing Co Ltd.

Entry Fee Enclosed : €                 / £ No Cash or Post-Dated Cheques Accepted

Details Required - Entrant Only if Other Than Rider

Name ____________________________________________________________________________________

Address _________________________________________________________________________________

Affiliated Club _________________________________________Competition License No. ______________

In Consideration of this, my entry, I agree to save harmless and keep indemnified, the MCUI, the Motor Cycle Union of Ireland (Southern Centre) and promoting club(s) (including the Owners of Lessees of land used for the event) and their respective Officials, Servants, Representatives or Agents from and against all actions, claims, costs, expenses and demands in respect of death of or injury to or loss of or damage to, the person or property of myself, my driver(s), my passengers(s) or mechanic(s) as the case may be howsoever caused arising out of or in connection with my entry or my taking part in this event, notwithstanding that the same may have been contributed to or occasional by the said bodies, their Officials, Servants, Representatives or Agents. In respect of any part of this event on grounds where third party insurance is not required by law, this agreement shall, in addition to the parties named above, extend to all and any other competitors and their servants and agents and to all actions, claims costs and expenses and demands in respect of loss or damage to the persons or property of myself, my driver, passenger or mechanic(s) I agree to act in accordance with the instruction of the officials of the event. I agree that the Preparation and Safety of my motorcycle(s) for Racing Conditions is my sole responsibility. I state that I am a member of an affiliated club of the MCUI and/or FIM and that I understand the GCR of the MCUI and the supplementary regulations of this event and accept same. I have read and understand the flag signals.

There is no onus on the Race Secretary to return an imperfectly completed form for amendment. The return of this form, properly completed, with fee, etc does not indicate final acceptance of the entry.

Roads Close at 11.30 a.m. Sharp on Sat 27^th June for Practice
10.00 a.m. Sharp Sun 28^th June on Race Day
Only entrants with official M.C.U.I. /A.C.U. /S.A.C.U. license will be accepted as an entrant

ENTRIES CLOSE ON FRIDAY 14th June 2009 – entry confirmation will be sent out after this date

RETURN ENTRIES TO: Joanne Kelly-Walsh, Lahesrough, Ballybunion, Co. Kerry.
Phone: 087-0523289 - email:  This e-mail address is being protected from spambots. You need JavaScript enabled to view it

I declare that the foregoing particulars are true and complete to the best of my knowledge. I further declare that I have read the Rules and Regulations governing the event and agree to abide by them. I admit the right of the promoters to refuse any entry without assigning a reason.

Full Name (Block Capitals) _____________________________________________________

Signature of Rider _________________________________________ Date ____________

Signature of Entrant ______________________________________ Date ____________

Signature of Parent or Guardian (if under 18 years of age) ___________________________

Additional Information required: