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FOREST OF DEAN

 AUTOGRASS CLUB (-F)

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         MAGOR RACEWAY, NEWPORT, MONMOUTHSHIRE, NP26 5PT

FOREST OF DEAN

LICENCE APPLICATION 

Please follow the process below to apply for a National Autograss Licence and become a member of Forest of Dean Autograss Club. This process if for new and existing membership.

If you have any club queries please contact Mike Liddiatt on 07968998412 or email mike.liddiatt309@btinternet.com

NATIONAL AUTOGRASS SPORT ASSOCIATION LTD.

LICENCE APPLICATION FORM

(FOREST OF DEAN)

By completing this form you are giving consent to Forest of Dean Autograss Club to apply on your behalf for the issue of a NASA licence in the category you select below.

Please complete all details for the applicant (intended licence holders) and tick the "terms and conditions" box . Ensuring that you provide your signature on this application.

In addition, please tick the "medical declaration" ONLY if this applies to you. 

APPLICANT DETAILS (INTENDED LICENCE HOLDER)

LICENCE INFORMATION

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Expires 31/01/2022

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CAR INFORMATION AND RACE NUMBER

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I have read, understood and agree to abide by the rules covering Autograss Racing as issued by the National Autograss Sport Association Ltd. (NASA) I further agree to save harmless and keep indemnified the Club, N.A.S.A. and the respective officials, members, landowners, servants, representatives and agents and / or drivers and mechanics from all actions, claims, costs, expenses, and demands in respect of loss, death or injury to myself, howsoever caused, notwithstanding that the same may have contributed to, or occasioned by, the negligence of several persons or bodies otherwise than in connection with the business or activities of the Club or NASA Ltd., and further to keep indemnified the said parties in respect of death, injury, or loss sustained by any third party as a result of the member negligence and / or breach of contract, save in so far as in either event the said liability is covered by a policy of insurance. I further realise that I shall take part in the sport of Autograss Racing entirely at my own risk.

Please tick this box if you have a medical condition or disability such as epilepsy, are without ar,s/legs/hands, mental or physical incapacity or failure to read a UK registration plate from 25 yards or are colour blind, and supply a suitable doctor's letter confirming that you may safely participate in Autograss Racing.

Please sign to state you  agree to share your information with National Autograss Sport Association Ltd.

Applicant's Signature

SUBMITTING YOUR APPLICATION WILL TAKE YOU TO THE PAYMENT SCREEN

(PLEASE DO NOT REFRESH YOUR SCREEN)

PARENT GUARDIAN DECLARATION.

Only the child's parent may sign this form, or such person who has been appointed by the court as guardian or foster parent of the child.

Please read the terms of this consent carefully, if you do not understand anything then ask your local Club Secretary for clarification. It is designed to create a legal relationship between you and ourselves and, by signing the document where required, you confirm that you have read this document and agree to abide by its terms and conditions and requirements.

Autograss Racing is a sport that minors may participate in with their parents' consent. It is not organised primarily for minors but their involvement is encouraged providing they and their parents understand the hazards that are associated with the sport. Motor racing is dangerous and may involve the risk of injury or death.

1. You should read and understand the current issue of the Members Handbook before signing this form. This is available in hard copy from your club secretary.
2. You, the signatory to this document, are ultimately responsible for your child at all times whether you are present at the NASA meeting with them or not and by signing this form you confirm that your child is physically fit and competent to take part in the type of events for which you are allowing him or her to participate.
3. If you do not attend any NASA meeting with your child you must arrange for a NASA Licence holding adult (over 18) who holds a Full or Mechanic's Licence to take charge of your child throughout your child's period of attendance at that meeting – including night time where applicable. You will agree that responsibility with that adult beforehand and your child is to clearly understand who their guardian is throughout the period.
4. If and when asked by a NASA official, your child will tell the official who their guardian is on the day. Failure to have a guardian present will result in your child taking no further part in the event and you being contacted and asked to remove the child.
5. You, as next of kin and person responsible will provide your name and address at the time of licence application. You are also to print this address in your child's licence in the space provided when it is issued. You will also provide two emergency telephone numbers which you will also print in their NASA licence. If this information is not in the applicant's licence then they will not be permitted to sign on to race.
6. Upon receipt your child will sign their NASA Licence and you, the same person who has signed this form will countersign.
7. You undertake to ensure that your child will carry their NASA Licence with them at all times whilst present at a NASA meeting – including evenings.
8. Your child will show any NASA official their licence upon request and without question.
9. You are to ensure that your child, if under 16 years does not drink alcohol at any time during their presence at a race meeting – day or night.
10. Your child may be breathalysed at any time of the day or evening. The procedures for testing and the penalties for failure are clearly set out in the Members' Handbook and will be applied to your child in the same way as they are to an adult.
11. You will ensure that your child's race car (where applicable) has been constructed in accordance with NASA regulations, is maintained in safe order and is built with regard to your child's size and stature and is suitable and safe to take part in the event for which that child is entered.
12. You are responsible for ensuring their seat harness; helmet and safety clothing are appropriate and maintained in good order.
13. If your child is under 16 years of age you are to ensure that they understand that they must not handle fuel or re-fuel the car. If you are not present this must be done by the child's guardian who must be present in the pit area.
14. Your child will subject their car to scrutineering with them driving the car in exactly the same manner as is required from adult members.
15. He/she will take note of scrutineers' comments and act upon them or advise you or their guardian to do so. NASA scrutineers are expected to treat all members courteously and will make no special provisions when dealing with minors.
16. You or the child's guardian are encouraged to be present during the scrutineering exercise providing you are a NASA licence holder (member/mechanic or full) and are wearing overalls.
17. You may only be present in the pits during racing if you hold a NASA Mechanic's or Full Licence and are wearing overalls and have signed on. If you are unable to do that you must refer all pit work, including re-fuelling (for under 16s) to the guardian you have nominated for the day.
18. You will ensure that your child will Sign On to race in the same manner as adults do. You should familiarise yourself with the indemnity clauses printed on the Signing On sheet and accept them as though you had signed yourself. You can obtain a copy from your club secretary.
19. You agree that your child will be subject to exactly the same race day discipline as adults. Marshals and organisers will give instructions to your child in the same manner they will give them to adults.
20. If your child misbehaves in any way you agree that they may be evicted from the meeting. This will require you and/or their guardian also leaving the meeting.
21. Your child will be subject to the same disciplinary procedures that adult members are subject to.
22. If your child is unfortunate enough to be involved in an accident – racing or otherwise, you accept that first aid treatment will be given by the first aid providers present.
23. You accept that marshals and NASA officials may need to cut and further damage the race car to extract your child in the way they see best. They – marshals and other NASA officials - may need to make physical contact with your child during this exercise. This will be done under the guidance of first aiders present but the decision of the officials present is final. If you are present at the meeting you may be invited to attend the scene of the accident and assist but this is at the discretion of the Chief Marshal.
24. After initial treatment they may advise further treatment and or precautions to be taken. You or the guardian present may consider if such advice is to be followed. However if the first aider states that an examination is required and you reject this or if in their opinion the child should refrain from participating for the rest of the day/meeting or give any other advice and then you or the guardian reject this then the child will take
no further part in the meeting.
25. Medical examinations will only be conducted by qualified and certified first aiders.
26. If your child has any problem during the day they should discuss with you or their guardian for advice. If you or the guardian wants clarification or guidance for the child then you should discuss with the appropriate NASA official present who will give it.
27. If you, your child or their guardian (in respect of their responsibilities to your child) are at any time abusive to any NASA official then you will all be ejected from the race meeting and normal disciplinary procedures will follow.
28. Furthermore, you and the licence applicant have read, understood and agree to abide by the rules covering Autograss Racing as issued by the National Autograss Sport Association Ltd.

I agree and confirm that I have informed my child of the risks associated with the sport and further confirm that both I and my child acknowledge and accept the risk of participating.

 

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