ABERDEEN & DISTRICT MOTOCROSS CLUB

CLUB MEMBERSHIP APPLICATION 2018

APPLICANT(S) INFORMATION

Rider Name(s):

Date of birth: Age(s): Nationality:

Address:

City: County: Post Code:

Phone: Email:
Parent / Guardian Name:
(for riders under 18 yrs)
Sponsors:

Do you require an MCF competition race licence through ADMCC ?

MACHINE INFORMATION

Make: Model: Engine Size (cc):

Preferred Race No: Transponder No:

DECLARATION
I, the undersigned, apply to enter any ADMCC events held by the club.
In consideration of being permitted to participate in these events, I declare as follows:
That I have read the Codes of Practice and Regulations for the MC Federation, the Event Regulations and entry form (when applicable) and I
agree to be bound by them in every respect.
That I am fit and not suffering from any physical or mental disability which would impair my safe participation in the event.
I undertake to inform the ADMCC immediately should any change in my condition occur which I have reason to or ought to have reason to
believe would affect my ability to participate in this competition.
That I will complete a medical questionnaire form (as requested during your licence application) and that I will inform the MC Federation &
ADMCC should my medical status change.
As a participant I may be exposed to the risk inherent in motor sport and that I am prepared to take such risks. I further agree that I shall
not seek to claim against MC Federation, the organisers ADMCC, their officials, the land owners, the promoter or other bodies or individuals
connected with the event(s) in respect of any damage to my property or injury howsoever caused, and whether by negligence or breach of
statutory duty of the said bodies or persons.
MC Federation or ADMCC do not provide personal accident insurance.

Signed by Rider:... Date:..

Signed by Parent / Guardian:.. Date:..

(for riders under 18 yrs)
Print name of Parent / Guardian:....... Date:..

Suggestions for the club or events:

Please send your application to: Shona Grant, Parkside Croft, Methlick, Ellon. AB41 7BT. Queries 01651 806801
Only members will be added to the Club Championship
Closing Date for membership application entries: 2018 Club Championship Round 2
No refunds will be given for membership after application is processed

I enclose my membership fee of (please circle):

25 - Adults 15 - Youth Under 16s 30 - Family 5 - Non Riding Member

(Family = 1 Adult & 2x Under 16s)

Please make cheques payable to Aberdeen & District MCC

For Official use only

Received from (Members Name): The Sum of ..

For the 2018 membership of Aberdeen & District MCC

Membership No:. Signature:..

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