WAC/CCC Targa Rally ~ Marshal Registration Form

Marshal Registration Form
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Marshal List

WAC/CCC Targa Rally ~ 1st September 2024

Marshal Registration Form

Please register to marshal using this form.

Please make sure your email address, mobile phone number and postal address are correct.

Marshal

Password To allow you to update your details and sign on later. Keep a note of this.

Name

Address

Postcode

Telephone

Mobile

Motorsport UK ID Number

Licence type and grade

Age Under 18 18+

Person to contact in case of emergency

Name

Relationship

Address Including Postcode

Mobile

At Event? No Yes

Main Role Marshal Radio Event Official Media
If you are an Event Official, put your role in the "Group Name" field.

Group Name
If you want to marshal together with another marshal or marshals, then give yourselves a group name and use it for each marshal in the group.

Experience Newcomer Test Start Test Finish Passage Control General Test marshal Other (please specify)

Other Experience

Radio Callsign

Radio Type Hand-held Vehicle set

Car

Make

Model

Registration

Carbon Footprint

Distance to travel to the event miles one way

MARSHAL/OFFICIALS' SIGNING-ON

Organising Club: Anglia Motor Sport Club		Permit No(s): 136923/136926
Event Name: WAC/CCC Targa Rally		Event Date: 1st September 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 www.motorsportuk.org/data-protection. 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

Signature: Typed signature is acceptable and is legally binding

Date:

If Under 18 - Marshal's Parent/Guardian/Guarantor

Name

Mobile

Signature: Typed signature is acceptable and is legally binding

Date:

Anglia Motor Sport Club complies with current data protection legislation. I agree that the information submitted through this form, including names, addresses and contact details, may be published or released to other parties purely for purposes connected with the event.

If a required field is not filled in, the form will scroll to that field so you can complete it before trying to submit the entry again.

Marshal System via MTC1.uk