Pioneer Run Entry Form [2009] - Sunbeam MCC

Sunbeam Motor Cycle Club71 st Pioneer Run Entry FormSunday 22nd March 2009Entries Close 31st December 2008Any entries received after this date will be charged at £50Driver DetailsFirst Name:Address:Please use CAPITAL LETTERS when filling out this form.Surname:Postcode:Date of Birth: / /Passenger First Name:Address (If different):Telephone Number:Club:Passenger Surname:If you have previously entered the Pioneer Run please state the last year that you participated:Machine DetailsMake:Manufacture Date:Solo / Tricycle / Forecar / Sidecar:HP or CC:Registration Number:Pioneer Cert. N°:The Pioneer Certificate Number is compulsory and MUST be filled in. Please ensure that the certificate matches the bikeLatest date for registration on the Pioneer Register is 1st January 2009The Registrar is: J. Waghorn, 46 High Road, Wilmington, Dartford, Kent, DA2 7BN. Telephone: +44 (0)1322 224605DeclarationI, the undersigned, apply to enter the event described above and in consideration therefore I hereby declare that I have read and understand the NationalSporting Code of the ACU, the ACU Standing Regulations and agree to be bound by them together with such Supplementary Regulations which may beissued for the event.I further declare that I am physically and mentally fit to take part in the event and competent to do so.I confirm that I understand the nature and type of events and the risk inherent with the sport and agree to accept the same notwithstanding that such risks mayinvolve negligence on the part of the organisers/officials.I further agree that I shall not seek to claim against the ACU, the organisers nor their officials, the landowners, the promoter or other bodies or individualsconnected with the event in respect of any damage to my property howsoever caused, and whether by the negligence or breach of stationary duty of the saidbodies and persons.I further agree that the machine which I enter and compete on shall be suitable and proper for its purpose and that it will comply with the regulations in respectthereof, and is described above.I understand and agree that I am required as soon as I arrive at the venue to register my arrival and sign-on at the designated area.I declare that the vehicle has a Road Fund Licence and MOT Certificate both for the duration of this event. Furthermore and additionally, I declare that inrespect of any part of this event held in circumstances to which the Road Traffic Act applies, I have an operative policy of insurance covering me in respect ofRoad Traffic Act liabilities and a current driving licence for the class of vehicle to which this entry relates.SignaturesSignature of entrant:Signature of parentor guardian (If under18 years old):Date: / /

Entry FeesPrice (Each)QuantityTotal PriceEntry Fee if you’re a Sunbeam MCC Club member£ 25.00£Please tell us your Membership N°:If you select this option, please pay next year’ssubscription fees with this entryEntry Fee if you’re NOT a Sunbeam MCC Club member ££ 30.00I wish to renew membership or join the Sunbeam MMC: ££ 15.00Extra Handling Charge for NON E.E.C Entries: ££ 5.00Insurance Fee for any passengers: ££ 1.50Extra Programs: (Sorry, these MUST be collected at start of the event) ££ 2.00Extra Lapel Badge for passenger ££ 3.00* V.I.P Car Parking facilities at Brighton (Includes Programme): £ 18.00£* V.I.P Car Parking - Maximum of ONE per entrant.Grand Total: £Payment and Delivery Information• Please enclose all payments with this entry form• UK Sterling Cheques should be made payable to ‘SUNBEAM MCC LTD’• For entries from other countries (including the E.U) please note that additional programmes cannot besent by post and MUST be collected at the start• We accept payment from ONLY these methods:1. Payment by cheque drawn on a UK bank in Pound Sterling2. Payment by cash in Pound SterlingEntries made any other way will be rejected and returnedCompleted entry forms together with your cheque are to be sent to the entry secretary:Ian D. McGillThe Oaktree13, Victoria RoadHorleySurreyRH6 9BNTelephone:+44 (0)1293 771446 [from abroad](01293) 771446 [from UK]Email: acsociable@tiscali.co.ukEntries must arrive no later than 31 st December 2008Address LabelsYou must include a completedaddress label which will be used tosend your final instructions, ridingnumbers, passes, programmes etc.Data Protection ActThe club holds administration information for this event on acomputer system. It is not released to anyone outside the clubofficials responsible for that event. If you do not want your detailsheld on computer, please tick this boxWe regret that your entry will be returned.Dutch Horsepower Team AwardI wish to compete for this award with the following nominated entrants:Name:Name:Class:Class:Signature:Don’t Forget - The start time is at 8:00 AMThe Sunbeam Motor Cycle ClubRegistered in England No. 3011502Website: http://sunbeam-mcc.co.uk/?p=pioneer | Email: info@sunbeam-mcc.co.uk