EmailMe Form -

Name

Address

Contact Number

Adult/Youth/Junior

Date of birth if under 18

Lic no:

Grade

Junior Grade

Next of Kin Name

Next of Kin Contact Number

Have you paid on Paypal/Revolute? €50Adults/€30 Youth/€25 Junior/€10 Minder

Have you read and accepted the event waiver below (required)
As a Competitor in this event I make this acknowledgement and acceptance of risk and waiver of my legal

rights for the benefit of Motor Cycling Ireland which in this agreement means the company Motor Cycle Union of Ireland (Southern Centre) Limited, its officers, staff, volunteers, race officials, emergency responders, servants and agents or any of the aforementioned persons.

I Acknowledge that I am voluntarily and willingly accepting and assuming the risk that as a competitor I may suffer injury, death, loss or damage and I comprehend the nature and extent of those risks.

I Waive, to the full extent permitted by law, any claim I may have as a competitor against Motor Cycling Ireland

in respect of any injury, death, loss or damage suffered, howsoever caused

I confirm that this Acknowledgement & Waiver can be relied upon in the defence of any action brought by me or my successors or assigns or surviving dependants against Motor Cycling Ireland, as defined above.

I acknowledge that motor cycling events are very dangerous and involve the risk of serious injury, death, loss or damage including property damage and that the actions and failures of Motor Cycling Ireland, as defined above, can cause or contribute to accidents and injury.

I am aware that the design and condition of an event site and the state of the premises, including the race course and competitors paddocks, can also cause or contribute to accidents and injury to competitors.

I confirm that my decision to compete on the day of an event will be made after I have satisfied myself as to the following matters;

a. The suitability and condition of my vehicle and protective equipment.

b. That I have the appropriate knowledge, experience and skill to compete in the events for which I have been entered.

c. The design, lay-out and condition of the race course.

d. The weather conditions.

e. That I am familiar with the current rules and regulations governing the event.

I confirm that I am aware that I can on the day of an event withdraw from entering an event or retire from an event in progress.

I confirm that I was given, and I understand, final instructions either in writing or as a riders briefing

I consent to details of any injuries I may suffer at this event being passed between all medical services and the Clerk of the Course/ Secretary of the Meeting

If under 18 my parent/guardian has read above and has signed on my behalf