Motorcycle Track Day Registration Form (MSV05)

For office use only Date: ___________________ Venue: Brands Hatch / Oulton Park / Snetterton / Cadwell Park
Licence checked? Yes/No Initial: ___________ Wristband Number: ___________________

Participant Surname: ___________________________ First Name(s): __________________________________

Date of Birth: __________________________________
House name/number: ____________________________ Street: _____________________________________________
Town: _________________________________________ County: ____________________________________________
Postcode: _______________________________________
Tel No (day): ___________________________________ Mobile: _____________________________________________
Email: _________________________________________
Please describe your experience as a rider: Novice / Intermediate / Experienced / Race experienced
Emergency Contact Details
Person to contact in an emergency: ____________________________________________________________________
Relationship: _________________________________ Tel No (day): __________________________________________
Address: ___________________________________________________________________________________________
_____________________________________________ Postcode: _____________________________________________

PERFORMANCE RIDING CAN BE DANGEROUS AND MAY INVOLVE INJURY OR DEATH

You must read and sign the following declaration as a condition of your participation in
any track day at the Venue.
In consideration for being permitted to participate in this track day by MotorSport Vision Limited (“MSV”) I accept, agree and confirm that:

1. I am familiar with the nature of the activity I wish to undertake and accept that, despite MSV taking all reasonable precautions, damage and injury
may occur. I accept these risks and take part in this activity at my own risk.
2. I am competent to take part, I am not taking any drugs (whether prescribed or otherwise) that may impair my ability to take part and I do not suffer
from, and have no history of, any medical condition that could affect my ability to take part in this event.
3. I will satisfy myself (by sighting lap or otherwise) before taking part in any activity that the Venue and the track is acceptable to me with regard to its
features and physical layout.
4. I have read, understood, agree and will comply with the track regulations and supplementary regulations and I will promptly comply with the
instructions and directions given by the organisers and instructors and any other representative of MSV at all times whilst attending at the Venue. In
the interests of safety the organisers or instructors may exclude me from further participation in the event if they think I am riding recklessly or
dangerously. I am aware and accept that other participants will be on the track at the same time as me.
5. I am over 18 years old and I hold a full valid DVLA and/or ACU motorcycle licence appropriate for the vehicle I intend to use and have produced it to
MSV for inspection.
6. The vehicle I intend to use is safe, complies with any relevant regulations (including without limitation relevant track regulations) and is fit to use for
the purpose(s) for which I have attended the Venue. Any on-bike camera or other equipment is safely and securely attached, using bolt-on mounting
systems specifically designed for that purpose (not suction or other temporary mountings). I understand that MSV’s insurance does not cover
damage to my vehicle (whether controlled be me or any other person) at this event, and that MSV recommend that participants procure their own
track day insurance. Therefore the use of my vehicle is at my risk and I take responsibility for any damage caused to my vehicle (whether controlled
be me or any other person).
7. My use of any vehicles made available by third parties, e.g. motorcycle manufacturers or retailers, may require me to sign an additional registration
form or indemnity for the third party. I recognise and agree that any such form is separate to and will not amend or replace in any way the continuing
applicability of the declarations made by me in this Registration Form.
8. Full protective equipment (including without limitation a properly fastened crash helmet) and clothing must be worn my me at all times whilst using my
vehicle.
9. Any damage caused by my reckless or dangerous riding shall be my responsibility, and I shall pay to MSV an amount equal to the cost of any
resulting repair or replacement.
10. No claim of any kind arising from my own negligence, error or omission or otherwise (including without limitation in respect of any damage to any
motorcycle or other equipment I intend to use at the event) shall be made by me, my guests or on my behalf or on behalf of any of my dependants
against MSV, JPM Limited, the organisers, any instructor(s) or any company or organisation connected with the event (each a “Relevant Person”)
or any of their respective employees, agents or assistants, or any other participant in the event.
11. Neither MSV nor any other Relevant Person shall be liable for any loss, damage, claims, costs, expenses, injury or demands suffered directly or
indirectly by me as a consequence of my attendance at or participation in this Activity provided that nothing in this form shall exclude any Relevant
Person’s liability for personal injury or death caused by its negligence. I shall reimburse MSV and other Relevant Persons against any loss or
liability suffered by them as a result of my error, default, act or omission.
12. MSV may take photographs and/or footage of me during this event and MSV may use such photographs or footage (including my likeness and
image) for future promotional, marketing and publicity purposes in any media worldwide without notice or payment.
13. Any material filmed or recorded by me at the Venue is for personal use only and is not for broadcast (whether for commercial reasons or otherwise)
on any public transmission media anywhere in the world (including but not limited to internet, terrestrial, cable or satellite), and I agree to pay
MotorSport Vision the sum of £25,000 if any material filmed should appear on such media.

Agreed and accepted

Participant Signature: _____________________________________________________ Date: ___________________

MotorSport Vision and PalmerSport run an exciting range of performance driving, motor sport and motor racing events. As we believe you are a
keen driver or rider we would like to advise you of these events and exclusive offers, exciting new products and special deals, including by email.
If you would prefer not to receive this information, please tick here: □

© MSV 2010. v.1 20.01.10