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MEMBERSHIP FORM arenacrossuk.com e22sports #axuk MANCHESTER GLASGOW BELFAST BIRMINGHAM NEWCASTLE SHEFFIELD LONDON Manchester Arena Sat 2nd January SSE Hydro Arena Sat 9th January Sun 10th January The SSE Arena Fri 15th January Sat 16th January Genting Arena Sat 23rd January Sun 24th January Metro Radio Arena Sat 30thJanuary Sun 31st January Motorpoint Arena Sat 13th February The SSE Arena Sat 27th February Event Schedule2016 Round 1 – Saturday 2nd January, Manchester Arena, Manchester Rounds 2 & 3 – Saturday 9th & Sunday 10th January, SSE Hydro Arena, Glasgow Rounds 4 & 5 – Friday 15th & Saturday 16th January, SSE Arena, Belfast Rounds 6 & 7 – Saturday 23rd & Sunday 24th January, Genting Arena, Birmingham Rounds 8 & 9 – Saturday 30th & Sunday 31st January, Metro Radio Arena, Newcastle Round 10 – Saturday 13th February, Sheffield Arena, Sheffield Round 11 – Saturday 27th February, SSE Arena, Wembley, London Please note that we are only taking a maximum of 12 riders in each youth class with the best 10 results from 11 rounds to count for the Championship! Each youth rider will take part in: 1 x Timed Practice sessions (daytime) 1 x Timed qualification session (daytime) 1 x Day Time race (not public) 1 x Evening race (all riders guaranteed to race as there are only 12 riders per class) Please note the qualification is for start line positions only. ALL riders accepted already qualify for the show performance. arenacrossuk.com e22 Sports Limited The Stables, Little Baldon Farm, Little Baldon, Oxon OX44 9PU - 17:00 1 MEMBERSHIP FORM arenacrossuk.com e22sports #axuk MANCHESTER GLASGOW BELFAST BIRMINGHAM NEWCASTLE SHEFFIELD LONDON Manchester Arena Sat 2nd January SSE Hydro Arena Sat 9th January Sun 10th January The SSE Arena Fri 15th January Sat 16th January Genting Arena Sat 23rd January Sun 24th January Metro Radio Arena Sat 30thJanuary Sun 31st January Motorpoint Arena Sat 13th February The SSE Arena Sat 27th February Section 1 – RIDER DETAILS Please note that every rider is required to fill out every line of the application, as part filled in forms will not be accepted Competitor Rider’s First Name .................................................................................... Rider’s Surname ...................................................................................... Address ....................................................................................................................................................................................................................... Post Town ................................................................................................ County ..................................................................................................... Post Code ................................................................................................ Date of Birth ............................................................................................. Home Telephone ...................................................................................... Mobile 1 ................................................................................................... Mobile 2 ................................................................................................... Nationality ................................................................................................ Email ........................................................................................................................................................................................................................... Machine Make of Machine ...................................................................................... Engine Capacity ...................................................................................... Model ....................................................................................................... Year ......................................................................................................... Engine Stroke (delete) ..................... Two / Four ...................................... Transponder Number ............................................................................... Will you need to hire a transponder at each round .................................... YES / NO ................................................................................................. Preferred race number (NOT guaranteed) ................................................ OR ........................................................................................................... Main Sponsor ............................................................................................................................................................................................................... 2016 MCF Licence & Club Membership In order to take part in the 2016 Arenacross series, riders are required to become an annual member of an MCF Affiliated Youth MX Club (for youth riders only). For information on clubs please contact 08454 750057 or visit the MCF website. All Pro riders are required to take a FULL Pro Licence. All members are required to hold a (BLACK) 2016 MC Federation annual licence; forms and renewals are available at www.mcfederation.com arenacrossuk.com e22 Sports Limited The Stables, Little Baldon Farm, Little Baldon, Oxon OX44 9PU - 17:00 2 MEMBERSHIP FORM arenacrossuk.com e22sports #axuk MANCHESTER GLASGOW BELFAST BIRMINGHAM NEWCASTLE SHEFFIELD LONDON Manchester Arena Sat 2nd January SSE Hydro Arena Sat 9th January Sun 10th January The SSE Arena Fri 15th January Sat 16th January Genting Arena Sat 23rd January Sun 24th January Metro Radio Arena Sat 30thJanuary Sun 31st January Motorpoint Arena Sat 13th February The SSE Arena Sat 27th February Section 2 – MEMBERSHIPS Please note that every rider is required to fill out every line of the application, as part filled in forms will not be accepted 2016 Membership & Entry Fees £299.00 ☐ .......... £199.00 ☐ 65cc AX Youth ............................................................................... 65cc 2 stroke/110cc 4 stroke ............. £199.00 ☐ Super Mini AX Youth ............. £199.00 ☐ .................................................... £99.00 ☐ ......................................................... £99.00 ☐ AX Pro Class AX Pro Lites ................................................................................. ................................................................................... ............................................................... Open capacity class ................................. 125cc 2 Stroke/250cc 4 stroke 85cc 2 stroke/150cc 4 stroke *You will receive a £99 refund on your membership fee if you contest all rounds of the tour. Entry Fees Per Round (2 show rounds are £149) AX Pro & Lites Classes .......................................................... All Pro Riders AX Youth Classes ....................................................................... All Classes Entry fee includes: Track & Pit Access pass for the rider Track & Pit Access pass for one extra person A rider is entitled to purchase a maximum of three extra Track & Pit Access passes where you will gain daytime access throughout practice and qualification as well as a seated position within the riders seating block. You will need to purchase these from the individual Arenas directly; contact numbers and information on how to do so, will come out with your rider confirmation once you have been accepted. arenacrossuk.com e22 Sports Limited The Stables, Little Baldon Farm, Little Baldon, Oxon OX44 9PU - 17:00 3 MEMBERSHIP FORM arenacrossuk.com e22sports #axuk MANCHESTER GLASGOW BELFAST BIRMINGHAM NEWCASTLE SHEFFIELD LONDON Manchester Arena Sat 2nd January SSE Hydro Arena Sat 9th January Sun 10th January The SSE Arena Fri 15th January Sat 16th January Genting Arena Sat 23rd January Sun 24th January Metro Radio Arena Sat 30thJanuary Sun 31st January Motorpoint Arena Sat 13th February The SSE Arena Sat 27th February Section 3 – PAYMENT Please tick when appropriate Payment If paying by cheque please make it payable to “MC Federation Ltd” Credit/Debit Card Details Payments made by Credit Card are subject to a transaction charge Please fill out the following details if you are paying by credit or debit card Switch ☐ MasterCard ☐ Visa ☐ Amex ☐ Other ................................................................... Full name as it appears on the card .................................................................................................................................................. Card Number ☐☐☐☐|☐☐☐☐|☐☐☐☐|☐☐☐☐ Valid From Date ☐☐|☐☐ Until End Date ☐☐|☐☐ Security No. ☐☐ Issue No ☐☐ I hereby give permission to deduct the following amount from my card £ Card Holder Signature Date ............................................................. ........................................................................................................................................................................... ........................................................................................................................................................................................................................ arenacrossuk.com e22 Sports Limited The Stables, Little Baldon Farm, Little Baldon, Oxon OX44 9PU - 17:00 4 MEMBERSHIP FORM arenacrossuk.com e22sports #axuk MANCHESTER GLASGOW BELFAST BIRMINGHAM NEWCASTLE SHEFFIELD LONDON Manchester Arena Sat 2nd January SSE Hydro Arena Sat 9th January Sun 10th January The SSE Arena Fri 15th January Sat 16th January Genting Arena Sat 23rd January Sun 24th January Metro Radio Arena Sat 30thJanuary Sun 31st January Motorpoint Arena Sat 13th February The SSE Arena Sat 27th February Section 4 – DECLARATIONS Please tick when appropriate Declarations By completing and signing the 2016 Arenacross Membership Form you are committing to competing in a minimum of 10 rounds of the series. Withdrawals and refunds will only be considered with an accompanying medical certificate. By ticking this box you agree to these terms ☐ Competitor MEMBERSHIP FEES ARE NON REFUNDABLE I, the undersigned, apply to enter the series described in this membership form. In consideration of being permitted to participate in this chosen series I declare as follows: That I have read the Rules and Regulations for the MC Federation, the Supplementary Regulations and entry form (when applicable) and I agree to be bound by them in every respect. That I am fit and not suffering from any physical or mental disability, which would impair my safe participation in the event. I undertake to inform the MC Federation immediately should any change in my condition occur which I have reason to or ought to have reason to believe would affect my ability to participate in this series. That I have completed a medical questionnaire form (as requested during your licence application) and that I will inform the MC Federation should my medical status change. As a participant I may be exposed to the risk inherent in motor sport and that I am prepared to take such risks. I agree that I shall not seek to claim against MC Federation, the organisers, their officials, the land owners, the promoter or other bodies or individuals connected with the event(s) in respect of any damage to my property howsoever caused, and whether by negligence or breach of statutory duty of the said bodies or persons. I acknowledge and accept that MC Federation do not provide personal accident insurance. I further agree that photographs and video footage may be taken and used in the public domain. I have read and agree to the following declaration and paragraphs below, which are designed to create a legally binding relationship in return for being permitted to enter and compete in the series. 1. I confirm that the information on this Membership Form and the information and my acceptance of the terms of my MC Federation Competition Licence are correct. 2. I confirm that I understand the nature of the Competition Series I am entering and I am competent to take part. 3. I confirm that any vehicle that I use will comply with the regulations and will be safe and fit for use in the competition. 4. I will satisfy myself before taking part (by sighting lap or otherwise) that the venue and track is acceptable to me with regard to its features and physical layout (unless prohibited to do so). 5. I will NOT take part if I have any doubt about my ability or the safety of the venue. 6. I accept that competition in motor sport may involve the risk of injury or death and I agree to take part at my own risk. 7. Before taking part in the event I will read and be bound by and comply with any regulations and final instructions issued by the organisers, the circuit owners and the regulatory body. 8. I will not participate whilst under the influence of alcohol or intoxicating drugs and if I am taking any prescribed medication I will inform the event organiser and seek approval prior to participation. 9. I will take note of all instructions given to me by officials of the competitions. 10. I will take note of all instructions given to me by officials of the competitions. arenacrossuk.com e22 Sports Limited The Stables, Little Baldon Farm, Little Baldon, Oxon OX44 9PU - 17:00 5 MEMBERSHIP FORM arenacrossuk.com e22sports #axuk MANCHESTER GLASGOW BELFAST BIRMINGHAM NEWCASTLE SHEFFIELD LONDON Manchester Arena Sat 2nd January SSE Hydro Arena Sat 9th January Sun 10th January The SSE Arena Fri 15th January Sat 16th January Genting Arena Sat 23rd January Sun 24th January Metro Radio Arena Sat 30thJanuary Sun 31st January Motorpoint Arena Sat 13th February The SSE Arena Sat 27th February Section 4 – DECLARATIONS Please tick when appropriate If under the age of 18, my parent/guardian has read the above and signed the declaration and agreement below Signed by Rider ............................................................................ Date .................................................................................................... Print Name of Rider (Block Capitals) ................................................................................................................................................ Parent/Legal Guardian Declaration and Agreement (Riders under 18 years of age) To allow the applicant to enter this Competition Series you must agree to the matters set out below, which are designed to create legal obligations upon you. Sign below only if you agree. 1. I am the legal Parent/Guardian of ......................................................................................................................................................... 2. I have read the Membership Form and declarations completed by the applicant and confirm that the answers are true. 3. I confirm that he/she is competent to participate in the Competition Series and that any vehicle, which he/she will use, is safe and fit for the competition. 4. I will, before allowing him/her to take part, satisfy myself that the course and the facilities are safe and will inspect the same. 5. I also hereby AGREE that if the applicant should sustain any injury from any cause whilst taking part in the event and as a result bring a claim for compensation against either you, the organisers, officials, sponsors, entrants or owners of the venue I WILL INDEMNIFY AND PAY BACK TO YOU any sum which you may be required to pay as a result of such claim. Signed by Parent/Guardian ................................................. Print Name of Parent/Guardian (Block Capitals) Date .................................................................................................... ..................................................................................................................... I have completed all information required above and understand that if I have missed out answering any of these questions that my application for membership will not be accepted ☐ arenacrossuk.com e22 Sports Limited The Stables, Little Baldon Farm, Little Baldon, Oxon OX44 9PU - 17:00 6
