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License Application

License Application Form

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PARENT CONSENT

Consent Statement for applicants under 18 years old:

I,

Of

Am the parent/guardian of the above-named (“the minor”) who is under 18 years old.

I have read this document and understand its contents, including the exclusion of liability and assumption of risk, and have explained the contents to the minor. I consent to the minor attending/ participating in the event at his/her own risk.

Personal Details

    Particulars of Current JPJ Driving License

    Particulars of Affiliated Club Membership

    Emegency Contact

    License Category *

    Car Category

    Motorcycle Category

    Consent

    DECLARATION, APPLICANT SIGNATURE AND PARENT/LEGAL GUARDIAN CONTERSIGNATURE

    I hereby apply for a Novice (C), National (A) / (B), International (A) / (B) / (C) competition License for Rider or Driver and declare that I am eligible to hold such a License. I understand that disciplinary action will be taken against me if any information provided herewith are false or inaccurate.
    In consideration of the Motorsports Association of Malaysia (MAM) granting Competition License I undertake: -
    1) To be bound by the National Competition Rules of the MAM and the International Sporting Code of the FIM, FIA, CIK-FIA (whichever is applicable) and any amendments, appendices or additional thereto.
    2) To pay as liquidated damages for any breach of the National Competition Rules of MAM any sum awarded against me within the maxima set out in the National Competition Rules and Appendices.
    3) To save harmless the Motorsports Association of Malaysia (MAM) and their respective officials, servants, representative and against any actions, claims, costs, expenses and demands in respect of death, injury, loss of or damage to the persons or property of myself, my driver(s) or mechanic(s) as the case may be, arising out of or in connection with any entry or my taking part in any meeting and not withstanding that the same may have been contributed to occasioned by the negligence of the said bodies, their officials, servants, representatives or agents.
    4) To inform MAM at any time of the period of license, should I meet with an accident or any injury or any illness that requires hospitalization. I also give full permission for my medical records to be revealed to MAM and their officers.
    5) I have undergone and passed the medical examination required and Apt for the practice of motorsports, according to the FIA medical standard and I hereby indemnify MAM and hold MAM harmless from any and all claims, demands, losses, cause of action, damages, lawsuits and any other costs arising and relating from any act of mine during the validity of this license.
    6) I agree to be tested for drugs and alcohol and to be bound by the results of the test done by any laboratory in Malaysia and any method chosen by MAM and accept any sanction imposed.
    7) I agree not to organize or participate in any event, which are not sanctioned by the MAM. I will only participate in events, which are sanctioned by MAM or with prior permission from MAM.
    8) I agree to abide by all rules, regulations and codes imposed by MAM from time to time.

    I have read this document and understand its contents.

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