Application Form

In the form below, fields marked * are mandatory.
. Event status: For: Organising club: Approx. No. of Competitors: Venue: Date(s) (must include any official practice days): Commencing at (time): Third Party Road Traffic Act insurance is automatically included with the entry fee for all road events. Landowner’s indemnity (please email any additional ones to: Landowner’s name: Landowner’s address: Postcode: Name of Applicant: Address for all correspondence: Email address: Postcode: Daytime tel. No: Evening tel. No: * * * * * * * * * * * * * Discipline: * Event Title: Event Secretary Name: Event Secretary Email: * * * to: ACU MIDLAND CENTRE PERMIT APPLICATION FORM * Revenue to be obtained from the public? For a road event, please email all other Landowner names and addresses to the Permit Secretary Event details for the ACU website Landowner details (only for a new Landowner or change to details) Event Secretary Telephone: * Applicant details (only for a new applicant or changes to details) *

I hereby apply to the Auto-Cycle Union for a Permit to hold the following event under the National Sporting Code of the ACU, the Standing Regulations, Supplementary Regulations and any Final Instructions issued.

Please note: For permits requiring other centres notification / approval please use the ACU Permit Application form that can be download at PERMITS/ACU FORMS, and post it to the Permit Secretary.