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ClassicCarEntryForm 16 .pdf


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Classic Car Display

at
The Mid-Somerset Show
Show date: Sunday 21 August 2016

ENTRY FORM

(please use this form for one entry only)
CLOSING DATE FOR ENTRIES: 22nd JULY 2016

Name: .....................................................................................................................................................
Address: ..................................................................................................................................................
.......................................................................................

Postcode: ...............................................

Telephone: ...............................................................................................................................................
E-mail: .....................................................................................................................................................

Please arrive before 9 am on Show Day

Details of your exhibit:
Make: .......................................................................................................................................................
Model: ......................................................................................................................................................
HP/CC: .....................................................................................................................................................
Works or Registration No: ......................................... Year of Manufacture: .....................................
Additional information:...........................................................................................................................
...................................................................................................................................................................
...................................................................................................................................................................
DECLARATION: I delcare that during the whole period of the Rally, my entry will be covered by public liability
policy of insurance, including Rally use, having a limit of indemnity of not less than £1,000,000 for any one accident. I
further declare that in the case of any event taking place wholly or partly on the Public Highway, that the vehicle hereby
entered is covered by insurances’ as required by the Road Traffic Act 1960, which is valid for such part of this event as
shall take place on roads defined by the Act. I confirm that the driver(s) of any such vehicles entered, hold or has held
and is not disqualified from holding or obtaining a license to drive the vehicle of the appropriate class.

SIGNED:______________________________ AGE(if under 18)____________ DATE:___________________
Please return this form together with a SAE to:
Eric Thornborough c/o Mid Somerset Show Office, 3 Europa Court, Crowne Trading Estate, Shepton Mallet,
Somerset BA4 5QQ. Tel: 01749 347607 or email: secretary@midsomersetshow.org.uk

www.midsomersetshow.org.uk


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