Organising Club: Blackpalfrey Motor Club of Kent       Permit No(s): 134209/133982
Event Name: Hughes Rally       Event Date: 13th April 2024

All Officials and Marshals who volunteer at an Event must identify themselves by signing on in order to obtain Personal Accident Insurance cover.

They must also sign the following undertaking:

I agree to act in an official capacity at this Event and in consideration of this the Organising Club(s) have effected for my benefit a Personal Accident Insurance Policy for death or benefits as prescribed more specifically by the ASN.

I have been given an opportunity to read the General Regulations of Motorsport UK and, if any, the Official Documents for this Event and agree to be bound by them.

I declare that I am physically and mentally fit to carry out my duties and that I do not have any disabilities or mental health conditions that may affect my ability to carry out my duties. I declare that I have not consumed any substance which may adversely affect my ability to carry out my duties. I will inform the Organisers immediately should any change in my condition occur which I may have reason to believe would affect my ability to carry out my duties.

I acknowledge that I understand the nature and type of Competition and that I may be exposed to the potential risk and dangers inherent in motor sport and I will undertake my duties with their associated risks with due and proper regard for my safety and that of others. 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.

I hereby agree to abide by all ASN Codes, Guidelines and Policies and where applicable those of the FIA.

I understand that my personal data is being processed and retained by the Organisers and Motorsport UK solely for the purposes of running this Event and will be handled in accordance with the Motorsport UK Data Protection Policy which can be found at I understand that I can withdraw consent to process my personal data at any time by contacting the Organisers and/or Motorsport UK but that this may affect my ability to act as an Official.

MEDICAL PRACTITIONERS. All doctors attending Motorsport UK Events as medical officers must be fully registered with the General Medical Council, must be members of a recognised medical defence organisation and be covered for work outside a hospital. Doctors must be competent in the field in which they are working and must be aware that they are expected to provide themselves with such equipment as they deem necessary for the proper performance of their duties (G15.1).

Last Updated: 5th February 2024

Typed signature is acceptable and is legally binding

If Under 18 - Marshal's Parent/Guardian/Guarantor
Typed signature is acceptable and is legally binding

Person to contact in case of emergency
Including Postcode. Required by Police Authority in case of serious accident.

Carbon Footprint
miles one way