Performance Rally Insurance Order Form
Transcription
Performance Rally Insurance Order Form
Performance Rally Insurance Order Form Date of Application / Date de la demande: ___________________________________ Name of the Event / Nom du rallye: ________________________________________ Championship Status / Championnat: ______________________________________ Date(s) of the Event / Date(s) du rallye: ____________________________________ Location of the Event / Lieu du rallye: ______________________________________ Organizing Club / Club organisateur: ______________________________________ Number of Days / Nombre de jours: _______________________________________ Sponsors, property owners, etc, are automatically covered. If names are to be individually shown as ADDITIONAL INSURED PARTIES please list below / Les commanditaires, les propriétaires terriens, etc., ont automatiquement protégés. Si des noms doivent paraître de façon individuelle comme PARTIES ASSURÉES ADDITIONNELLES, veuillez les inscrire ci-dessous : Organizer contact information and whom Insurance Certificate should be sent to / Coordonnées de l’organisateur à qui le Certificat d’assurance doit être envoyé : Name / Nom: ____________________________________ Title / Titre :______________________________ Address / Adresse: _______________________________________________________________________ Email / Courriel:____________________________ Phone Home / Tél. (rés.): ________________________ Phone Business / Tél. (travail) : _________________________ Fax: ________________________ IMPORTANT This order form and a set of event regs, and a completed underwriting package MUST be received by CARS Thirty (30) days prior to your event. / Ce formulaire, le Règlement particulier du rallye et un dossier complet des mesures de sécurité DOIT parvenir à CARS au moins 30 jours avant la tenue de votre rallye. Canadian Association of Rallysport – Box 300, Turner Valley, AB, T0L 2A0 – 1 (855) 640-6444 carsrally.ca Affiliated with ASN Canada FIA CARS Performance Rally Underwriting Information For each CARS Performance Rally, the following underwriting information MUST be submitted to CARS for ASN Canada FIA. The underwriting information must be received thirty (30) days before the event and include a set of event regs. All information can be sent to the cars office at [email protected]. What is needed: 1. COURSE DESCRIPTION: A. Detailed maps of the roads to be utilized as stages during the rally, with starts and finishes marked, are needed. Hand drawn maps are acceptable. An overall map showing transits, services and the stages in relation to nearby centers is also required. Please highlight stages. B. A map showing the roads & where the area is in relation to a city/town. This could be a copy of the appropriate portion of a provincial road map. C. Stage details (length, surface, speeds, history, etc) D. Controls (number of personnel, locations) E. General terrain and anticipated weather conditions. F. Tentative schedule of the event including stage starts, stage finishes and services. 2. EVENT MANAGEMENT DESCRIPTION: A. Individual names of event officials and their experience B. Public notice procedures for road closures C. Communications system D. Course security procedures 3. SPECTATOR/PUBLIC VIEWING AREAS: A. Description of spectator areas B. Positive barrier protection or other protection and height of protective bank C. Crowd control procedures D. Spectator/public viewing area access and egress description E. Detailed map of the areas involved (showing placement of barricades/road blockage, radios, marshals, direction of rally traffic and [if any] spectator traffic and parking). Hand drawn maps are acceptable. 4. EMERGENCY FACILITIES: A. Medical attention (personnel, equipment, procedures) B. Nearest hospital and transportation plans This information must be submitted to CARS office prior to confirmation of coverage being issued. Please do not contact ASN Canada FIA directly. Canadian Association of Rallysport – Box 300, Turner Valley, AB, T0L 2A0 – 1 (855) 640-6444 carsrally.ca Affiliated with ASN Canada FIA