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Home » Stewards Report Form

Stewards Report Form

Fields marked with a * are required.

Meeting Details:

Meeting Date *

Start Time *

Finish Time *

Number of karts nominated *

Was event run under lights *

Yes
No

Was an Ambulance in Attendance *

Yes
No

Was St John / First Aid in Attendance *

Yes
No

Weather & Track Conditions

Additional Comments re Wether/Track/Pit Conditions

Stewards:

Chief Steward *

Chief Steward ADIKA License Number *

Starter

Starter AIDKA Licence Number

Steward No. 2

Steward 2 ADIKA License Number

Steward No. 3

Steward 3 ADIKA License Number

Steward No. 4

Steward 4 ADIKA License Number

Steward No. 5

Steward 5 ADIKA License Number

Steward No. 6

Steward 6 ADIKA License Number

Steward No. 7

Steward 7 ADIKA License Number

Steward No. 8

Steward 8 ADIKA License Number

Steward No. 9

Steward 9 ADIKA License Number

Steward No. 10

Steward 10 ADIKA License Number

Scrutineers

Chief Scrutineer *

Chief Scrutineer AIDKA License Number

Scrutineer No. 2

Scrutineer No. 2 AIDKA License Number

Scrutineer No. 3

Scrutineer No. 3 AIDKA License Number

Scrutineer No. 4

Scrutineer No. 4 AIDKA License Number

Incidents:

Were any major penalties applied? (enter details below) *

Yes
No

Penalty 1 Driver Name

Penalty 1 Licence Number

Penalty 1 Class *

Penalty 1 Rule Number *

Penalty 1 Type

Penalty 1 Details (if required)

Penalty 2 Driver Name

Penalty 2 Licence Number

Penalty 2 Rule Number

Penalty 2 Type

Penalty 3 Driver Name

Penalty 3 Licence Number

Penalty 3 Rule Number

Penalty 3 Type

Penalty 4 Driver Name

Penalty 4 Licence Number

Penalty 4 Rule Number

Penalty 4 Type

Penalty 5 Driver Name

Penalty 5 Licence Number

Penalty 5 Rule Number

Penalty 5 Type

Penalty 6 Driver Name

Penalty 6 Licence Number

Penalty 6 Rule Number

Penalty 6 Type

Penalty 7 Driver Name

Penalty 7 Licence Number

Penalty 7 Rule Number

Penalty 7 Type

Penalty 8 Driver Name

Penalty 8 Licence Number

Penalty 8 Rule Number

Penalty 8 Type

Were any Accident / Incident Forms Filled out *

Yes
No

Incident 1 Drivers Name

Incident 1 Licence Number

Incident 1 Class *

Incident 1 Race Number / Heat *

Were they treated by First Aid *

Yes
No

Was an Ambulance Required *

Yes
No

Incident 1 Is Medical Clearance Required

Yes
No

Incident 2 Drivers Name

Incident 2 Licence Number

Incident 2 Class

Incident 2 Race Number / Heat

Were they treated by First Aid

Yes
No

Was an Ambulance Required

Yes
No

Incident 2 Details

Incident 2 Is Medical Clearance Required

Yes
No

Incident 3 Drivers Name

Incident 3 Licence Number

Incident 3 Class

Incident 3 Race Number / Heat

Were they treated by First Aid

Yes
No

Was an Ambulance Required

Yes
No

Incident 3 Is Medical Clearance Required

Yes
No

Incident 1 Class *

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