Landowner's indemnity (please email any additional ones to: permit.secretary:midlandcentreacu.org.uk)

2011 CENTRE PERMIT APPLICATION FORM

Not for use by Non_Territorial Clubs or for Road Race events

Including application for Grant of Authorisation to organise an event under Section 13A of the

Road Traffic Act 1988 and the Motor Vehicles (Off-Road Events) Regulations 1995

I hereby apply to the Auto-Cycle Union for a Permit to hold the following event under the National Sporting Code of the

ACU, the Standing Regulations, Supplementary Regulations and any Final Instructions issued:-

Please select:

Discipline:

Organising club:

*

*

*

*

Venue:

*

Dates(s) (must include any official practice days):

*

Commencing at (time):

*

Please check this box if the event

will

obtain revenue from the public

Please select this box if the event

will not

obtain revenue from the public

Please check this box if the Road Traffic Act applies to any part of the course.

Permit fee (see current Midland Centre fixtures) £

Landowner's indemnity (please email any additional ones to: permit.secretary:midlandcentreacu.org.uk)

Landowner's name:

*

Landowner's address:

*

Postcode:

Name of applicant:

*

Address for all correspondence:

*

Postcode:

Daytime telephone number:

*

Evening telephone number:

email address:

*

*

Please check to equate to a signature

Child Protection Report Form

J4 - Decision of Stewards Hearing

J3 - Appeal Form

J2 - Decision of Clerk of Course

J1 - Protest Form

C9 - Parental Agreement Form Single Event

C7 - Press and Team Crew Signing-on Form

C6 - Officials and Assistants Signing-on Form

C4 - Riders and Passengers Signing-on Form - Adults and Minors

C3 - Riders and Passengers Signing-on Form - Adults only

C1 - Technical Inspection Report Form

B4 - Environment Checklist

B3 - Sound Inspector's Report

B1 - Injury / Incident / Accident Report Form

ACU forms required for your event

to be sent with insurance payment to Centre Treasurer

WebFormDesigner