Mercian
Dirt
Riders

Click here for Consent Form to print (PDF format)

Rider's Surname ...................................................   First Name(s) .......................................................

Address ...................................................................................................................................................

.................................................................. Post Code ...................................................

Tel. Number ............................................. Date of Birth .............................................

Valid for Trials, Enduro, & Hare & Hounds Events.  Held under the sporting code of the Auto-Cycle Union, the Standing Regulations, Supplementary Regulations and any final instructions which have been or may be issued.  Copies of the ACU national sporting code are available on application, with payment of £10.50, from the Auto Cycle Union, ACU House, Wood Street, Rugby, Warks, CV21 2YX.  Standing Regulations are published annually in the ACU Handbook.

Rider
Declaration :   I, ......................................... the Parent and/or Guardian of

................................................................... (Childs name)
(Hereinafter referred to as 'my/our child') accept that my/our child may wish to participate in the aforementioned meeting.  I declare as follows: -

That I am /we are familiar with the nature of the competition and the risk inherent therein and that other than where not provided for by the nature of the event, my/our child will have the opportunity to inspect the course/track/circuit and its facilities not less than 30 minutes prior to commencement of practice or event whichever occurs first.
1. I am/ we are satisfied and content that my/our child be allowed to participate as a competitor and that he/she is competent to do so.
2. In consideration of the organisers allowing my/our child to compete I hereby agree and undertake to indemnify the Auto-Cycle Union, the Organisers, their servants or agents, the landowners, the promoter or other bodies or individuals connected with the event in respect of any claim by my/our child in respect of injury or any damage to my property howsoever caused, and including without limitation their negligence and/or breach of statutory duty arising from my/our Childs participation in the competition.
3. My/ our child does not suffer from any physical or mental disability which would make it unsafe for him/her to participate as a competitor.
4. I/we confirm that I/we have had the opportunity to read, and that I/we consequently understand, the National Sporting Code of the ACU, the Standing Regulations, Supplementary Regulations, and Final Instructions subsequently issued and Entry Form applicable to this event, and that it is my/our responsibility to insure that my/our child understands them and that he/she will comply with them.
5. To the best of my/our belief my/our child possesses the standard of competence necessary for an event of the type to which his/her entry relates and that the machine entered will be suitable, safe and will comply with the Regulations for these events.