2013 ASTON MARTIN GT4 CHALLENGE OF GREAT BRITAIN ENTRY FORM

2013 Season entry fee £15,450 +VAT

2013 3 Round entry fee (please select races below) £6,556 +VAT

Individual event team entry fee See pricing below

2012 Aero Kit package £12,850 +VAT

Deposits and Final Balance

·  A deposit of £1,500 +VAT is required with the entry form to secure your 2013 entry.

·  A deposit of £1,500 +VAT is also required to secure the 2012 Aero Kit package.

·  The balance is to be paid in full including VAT as applicable before the first race you have entered.

Competitor Bonus

If there are a minimum of 20 full season entries, each entry will receive an end of season bonus of £3,000 per car (subject to the car having started a minimum of six out of seven races).

Season entrants are automatically entered into the 2013 Aston Martin Centenary Festival (Double Header) at Brands Hatch with a qualifying race on the Indy circuit on 6th July and the main race on the GP circuit on 7th July.

TEAM/ENTRANT DETAILS
TEAM NAME:
ADDRESS:
POSTCODE:
TELEPHONE:
INDIVIDUAL EVENTS:
(to be completed only if not competing in full series) / SILVERSTONE NATIONAL - 6 APRIL (100 laps) / £2350.00 +VAT / YES / NO
OULTON PARK INTERNATIONAL - 11 MAY (100mins) / £2350.00 +VAT / YES / NO
DONINGTON PARK - 1 JUNE (100 laps) / £2350.00 +VAT / YES / NO
BRANDS HATCH INDY - 6 JULY (100mins) / £2350.00 +VAT / YES / NO
CENTENARY FESTIVAL (BRANDS HATCH GP) - 7 JULY (100mins) / £2350.00 +VAT / YES / NO
SPA-FRANCORCHAMPS - 26/27 JULY (2 x 30mins,1 x 60mins) / £2350.00 +VAT / YES / NO
SNETTERTON 300 - 28 SEPTEMBER (100mins) / £2350.00 +VAT / YES / NO
DRIVER 1 DETAILS:
TEAM NAME:
ADDRESS:
POSTCODE:
TELEPHONE:
EMAIL:
LICENCE GRADE/ISSUING ASN:
LICENCE NO:
PERSON TO BE NOTIFIED IN CASE OF AN EMERGENCY:
NAME: / RELATIONSHIP:
ADDRESS:
TELEPHONE:
ALTERNATIVE PHONE NUMBER:
DRIVER 2 DETAILS:
NAME:
ADDRESS:
POSTCODE:
TELEPHONE:
EMAIL:
LICENCE GRADE/ISSUING ASN:
LICENCE NO:
PERSON TO BE NOTIFIED IN CASE OF AN EMERGENCY:
NAME: / RELATIONSHIP:
ADDRESS:
TELEPHONE:
ALTERNATIVE PHONE NUMBER:
DECLARATION:
1)  I have been given the opportunity to read the General Regulations of the Motor Sport Associations and the Series Regulations and, if any, the supplementary regulations for this event and agree to be bound by them. I declare that I am physically and mentally fit to take part in the event and I am competent to do so. I acknowledge that I understand the nature and type of the series and the potential risk inherent in motorsport and agree to accept that risk. 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.
2)  To the best of my belief the driver(s) possess(es) the standard of competence necessary for an event of the type to which this entry relates and that the vehicle entered is suitable and roadworthy for the event having regard to the course and the speeds which will be reached.
3)  I understand that should I at the time of the event be suffering from any disability whether permanent or temporary which is likely to affect prejudicially my normal control of my vehicle I may not take part unless I declared such a disability to the ASN which has, following such declaration issued alliance which permits me to do so.
4)  Any application form for a licence which was signed by a person under the age of 18 years was countersigned by that person's parent/guardian/guarantor, whose full names and addresses have been given.
5)  If I am the parent/guardian/guarantor of the driver I understand that I have the right to be present during any procedure being carried out under the Supplementary Regulations issued for this event and the General Regulations of the MSA.
DRIVER 1
SIGNATURE ______ / DATE:
DRIVER 2
SIGNATURE ______ / DATE:
TEAM PRINCIPAL
SIGNATURE ______ / DATE:
PARENT/GUARDIAN OF
DRIVER 1 AND/OR 2 ______ / DATE:

NOTE: Where a parent or guardian is not present at an event in which an under 18 is competing, there must be a representative who must produce a written and signed authorisation from the parent/guardian giving the under 18 year old into their care.

PLEASE RETURN YOU COMPLETED ENTRY FORM TO:

Sonia Mistry

GT4 Challenge Series Administrator

Aston Martin Racing, Oldwich Lane East, Kenilworth, Warwickshire, CV8 1NR

E | T +44 (0) 1676 536111 | M +44 (0) 7794 072291

PAYMENT TERMS:

·  A deposit of £1,500 is payable with the entry form to secure your entry, this deposit is non-refundable.

·  A non-refundable deposit of £1,500 is payable with entry form to secure the Aero Kit upgrade

·  Please request a proforma invoice in advance if this is required.

·  The deposit will be invoiced separately to the full outstanding balance.

·  If the invoice should be made out to a different name from the entry, please confirm on returning this form.

BANK DETAILS:

BANK ADDRESS: / BARCLAYS BANK PLC / ACCOUNT NAME: / PRODRIVE MOTORSPORT LTD
3,4,5 KING STREET / ACCOUNT NUMBER: / 30735876
READING / SORT CODE: / 20-71-06
BERKSHIRE / IBAN NUMBER: / GB98 BARC 2071 0630 7358 76
RG1 4BX / SWIFT CODE: / BARCGB22

Aston Martin Racing, Banbury, Oxfordshire, England, OX16 3ER

T: +44 (0)01295 754212 | E: | W: www.astonmartinracing.com Page 1 of 2