2014 Aston Martin GT4 Challenge Entry Form
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2014 ASTON MARTIN GT4 CHALLENGE ENTRY FORM
PACKAGE FOR EVERY CAR ENTERED
Entry to the race/s for one car with two drivers Tyre bonus: Full season entrants get 2 complimentary tyres per 2 sets purchased 4 x Team Hospitality passes for breakfast and lunch 8 x Personnel passes for access to the circuit 4 x Car parking passes AMR customer support parts truck AMR shared engineering support Trophy presentation at every round Entry into the Aston Martin Racing Global Challenge Invitation to end of season awards ceremony Photography at each event supplied royalty free for all competitors Factory tour of Aston Martin Racing for competitors guests and sponsors
RACE ENTRY FEE
Full Season: All races in 2014 £12,500 + vat YES / NO 1 Round Entry: Packages available for multi round entries. Contact for price. See Below Select Below
TEAM/ENTRANT DETAILS
Team Name: Address: Postcode: Telephone:
SELECT THE RACES YOU WILL ENTER
Race Format Date Fee Enter 30 minute qualifying Oulton Park 19 April £1,650 + vat YES / NO 60 minute race 30 minute qualifying Rockingham (ISSLC) 3 – 4 May £2,250 + vat YES / NO 2 x 60 minute races 30 minute qualifying Silverstone GP 31 May £2,250 + vat YES / NO 100 minute race 30 minute qualifying Brands Hatch Indy* 28 June £2,250 + vat YES / NO 100 minute race 30 minute qualifying Donington Park GP 13 – 14 September £2,250 + vat YES / NO 2 x 60 minute races 30 minute qualifying Zandvoort, Holland 19 October £2,250 + vat YES / NO 100 minute race
* Subject to confirmation
DRIVER 1 DETAILS
Team Name: Aston Martin Racing, Banbury, Oxfordshire, England, OX16 3ER Page 1 of 3 T: +44 (0) 1295 273 355 | E: [email protected] | W: www.astonmartinracing.com Address: Postcode: Telephone: Email: Licence Grade
Issuing ASN: Licence No: PERSON TO BE NOTIFIED IN CASE OF AN EMERGENCY: Name: Relationship: Address: Telephone: Alternative phone number:
DRIVER 2 DETAILS
Name: Address: Postcode: Telephone: Email: Licence Grade
Issuing ASN: Licence
Number:
PERSON TO BE NOTIFIED IN CASE OF AN EMERGENCY:
Name: Relationship: Address: Telephone: Alternative Phone Number:
DECLARATION
1) I have been given the opportunity to read the General Regulations of the Motor Sport Associations and the Series Regulations and, if any, the supplementary regulations for this event and agree to be bound by them. I declare that I am physically and mentally fit to take part in the event and I am competent to do so. I acknowledge that I understand the nature and type of the series and the potential risk inherent in motorsport and agree to accept that risk. Further I understand that all persons having any connection with the promotion and/or organisation and/or conduct of the event are insured against loss or injury caused through negligence. 2) To the best of my belief the driver(s) possess(es) the standard of competence necessary for an event of the type to which this entry relates and that the vehicle entered is suitable and roadworthy for the event having regard to the course and the speeds which will be reached. 3) I understand that should I at the time of the event be suffering from any disability whether permanent or temporary which is likely to affect prejudicially my normal control of my vehicle I may not take part unless I declared such a disability to the ASN which has, following such declaration issued alliance which permits me to do so. 4) Any application form for a licence which was signed by a person under the age of 18 years was countersigned by that person's parent/guardian/guarantor, whose full names and addresses have been given.
Aston Martin Racing, Banbury, Oxfordshire, England, OX16 3ER Page 2 of 3 T: +44 (0) 1295 273 355 | E: [email protected] | W: www.astonmartinracing.com 5) If I am the parent/guardian/guarantor of the driver I understand that I have the right to be present during any procedure being carried out under the Supplementary Regulations issued for this event and the General Regulations of the MSA.
Driver 1 Signature: DATE:
Driver 2 Signature: DATE:
Team Principle Signature: DATE:
Parent/Guardian of Driver 1: DATE:
Parent/Guardian of Driver 2: DATE:
NOTE: Where a parent or guardian is not present at an event in which an under 18 is competing, there must be a representative who must produce a written and signed authorisation from the parent/guardian giving the under 18 year old into their care.
PAYMENT TERMS
Full season entries are due in full at the time of submitting your entry Request a proforma if this is required for you to make payment If the invoice should be made out to a different name from the entry, please confirm on returning this form
PAYMENT OPTIONS
Credit/Debit card* Please call Sonia Mistry on +44 (0) 1295 273 355. * American Express subject to 2.75% surcharge. Bank Transfer Bank details below. Please send your payment reference with this form Cheque Please make payable to ‘PRODRIVE MOTORSPORT LTD’
BANK DETAILS
Bank Address: BARCLAYS BANK PLC Account Name: PRODRIVE MOTORSPORT LTD 3,4,5 KING STREET READING Account Number: 30735876 BERKSHIRE Sort Code: 20-71-06 RG1 4BX IBAN Number: GB98 BARC 2071 0630 7358 76 Swift Code: BARCGB22
PLEASE RETURN YOU COMPLETED ENTRY FORM TO
Sonia Mistry, GT4 Challenge Series Administrator Aston Martin Racing, Prodrive, Acorn Way, Banbury, OX16 3ER E [email protected] T +44 (0) 1295 273 355 M +44 (0) 7794 072 291
Aston Martin Racing, Banbury, Oxfordshire, England, OX16 3ER Page 3 of 3 T: +44 (0) 1295 273 355 | E: [email protected] | W: www.astonmartinracing.com