West Riding Omnibus Museum Trust

DEWSBURY BUS MUSEUM West Riding Omnibus Museum Trust Registered Charity 702232 APPLICATION TO BRING A VEHICLE AUTUMN OPEN DAY- SUNDAY 13th NOVEMBER 2016

YOUR DETAILS

Name:______Telephone: ______

Address: ______

______E-mail:______

I hereby apply to bring the following vehicle as (*please delete that which does not apply): a) STATIC EXHIBIT ONLY * b) BUS TO OPERATE ON FREE PUBLIC SERVICE *

There is no charge for the vehicle. Free admission to the Museum building will apply to the driver and one nominated assistant. The normal admission charge (£3.00, including Souvenir Programme booklet) will apply to all other passengers.

DETAILS OF BUS (If operating in service, a recent photograph would be appreciated).

Original operator:______Fleet number:______

Registration number:______Seating layout: (eg. H43/32F)______

Chassis:______Body:______Date new:______

DECLARATION I hereby certify that the use of the above vehicle at the above event is fully compliant with all the relevant legislation. In particular I declare the following: 1. I understand that this event is not opted out of the Road Traffic Act 1988 and confirm that the vehicle described above will be properly insured for the use to which it will be put, and, (if the bus is to operate on the free public service) that the following conditions apply; 2. The vehicle is being used with the permission of its owner. 3. The vehicle has a current appropriate MOT Test Certificate (if required) and is in a safe and roadworthy condition. 4. A "first use" check of the vehicle will be conducted on the day of the event and any defects entered in the log, which is kept on the vehicle. 5. The person who will drive the bus at the event holds a current Driver's Licence to the appropriate PCV standard for the vehicle, and by driving the vehicle at the above event the driver will be compliant with Drivers' Hours Regulations, both EEC and domestic. 6. No passengers will be carried for hire or reward, and no payment will be made for the use of the vehicle or the services of the driver. 7. I hereby indemnify the West Riding Omnibus Museum Trust against any claim or legal proceedings that may result from non-compliance with the above, or by any defect on the vehicle, or any act or omission on my part.

Signed:______Print name:______Date:______

ENQUIRIES can be made by email to [email protected] or by calling 0844 504 0089 (5p/min) or 01924 511458.

Please return this completed form to: Tony Salmon, 2 Liley Lane, Grange Moor, Wakefield, WF4 4DT.