APPLICATION FOR ONE DAY COMPETITION LICENCE

NAME: ………………………………………….......…….....................................................................................

ADDRESS: …………………………………………………………………………………………………………………..………………

…………………………………………………………………………………………   POST CODE ………………………………….

DATE OF BIRTH: ………………………………………... MALE/FEMALE* delete as appropriate

I wish to ride under a one event competition licence for the following motocross event organised by 90 Racing MXC:

 Date of Event: …………………………..Venue……………………………………………………

Medical Declaration

 1.      Have you ever been rejected or accepted at increased premiums for life insurance on medical grounds?                                                                                                           YES/NO*

 2.      Have you been treated for, do you now have, or have you ever had any of the following:
(a) Head injury?                                                                                                    YES/NO*
(b) Unconsciousness or concussion (within the last 28 days)?                             YES/NO*
(c) High blood pressure/heart disease or disorder?                                            YES/NO*
(d) Dizziness, fainting spells, epilepsy, fits or blackouts?                                     YES/NO*
(e) Disease, injury or operation to either eye?                                                    YES/NO*
(f) Do you have any vision defect or loss of sight in either eye?                         YES/NO*
(g) Do you have any condition which affects movement of arms or legs?          YES/NO*
(h) Do you have any false or missing limbs?                                                        YES/NO*

* If you have answered YES to any of the above, please complete further details below:

……………………………………………………………………………………………………………………………………………………………………

I sign below to certify that I have made a full true and accurate statement and I understand my license may be invalid/withdrawn should any prove not to be so.  I also authorise any hospital or medical practitioner to furnish information relative to my medical condition to 90 Racing MXC and/or Doodson Broking Group.

 Signature: …………………………………………….  Date: ……………………………………..

 Signature of Parent/Guardian: …………………………..…………(if under 18 years of age)

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Look on the Training page for the new CD released from Edmaster Performance Coaching! Ring Lynsey to purchase

Stolen bikes from
Peterborough on 11th July:

 85 and 450 ktm with numbers 31 on
and shapers printed on graphics. The 85 had an Ohlin suspension on and
the 450 has another suspension and exhaust on other than standard ones.
Also a Suzuki GXR 1000 blue and white road bike was taken at the same
time on 51 plate.
Any info please call & thanks Ann Whyatt - 07730526493

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