Damage Declaration

MGJ Engineering Brands Hatch Winter Stages

18th January 2025

Chelmsford Motor Club

Permit No(s): 200032

Car Number

Driver Name

I hereby declare that I have not been involved in any incident which may have caused damage to persons or property during the course of the event. Signature Typed signature is acceptable and is legally binding

Or else give details of any incident

Reason for Retirement (for results)

Number of tyres used

Brief description of types of tyres used and approximate wear during the event

You are required to submit this damage declaration within 72 hours of the event. Failure to return this form may be penalised by a fine of up to £100.

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