

PERSONAL INFORMATION
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Please fill out your information completely, if you are not with a company, leave the company information empty, otherwise fill out the company information to the best of your ability.
YOUR INFORMATION
Name: Arianna DeRose
Contact Number: 41663239
Event Role: President
Company/Organization: (N/A if not applicable)San Andreas Motor Racing Association
COMPANY INFORMATION
(Leave blank if not applicable)
Name of company/organization: San Andreas Motor Racing Association
Contact Person: Arianna DeRose
Contact Phone / Hotline: 41663239
Registered Address: SAMRA Garage, La Mesa, Los Santos
Please fill out your information completely, if you are not with a company, leave the company information empty, otherwise fill out the company information to the best of your ability.
YOUR INFORMATION
Name: Arianna DeRose
Contact Number: 41663239
Event Role: President
Company/Organization: (N/A if not applicable)San Andreas Motor Racing Association
COMPANY INFORMATION
(Leave blank if not applicable)
Name of company/organization: San Andreas Motor Racing Association
Contact Person: Arianna DeRose
Contact Phone / Hotline: 41663239
Registered Address: SAMRA Garage, La Mesa, Los Santos
EVENT DETAILS
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Please fill out this next section in it's entirety. If something cannot be answered, please put N/A or a short explanation depending on the reason. If you do not have a specific time, date or location decided then please estimate these answers to the best of your knowledge.
EVENT SPECIFICS
Event Name: Clunker Series 500
Location of Event: Sandy Shores Airfield
Date of Event: 10/12/2022
Start Time: 19:00
Planned End Time: 22:00
(Mark one of the below options with an X)
Please fill out this next section in it's entirety. If something cannot be answered, please put N/A or a short explanation depending on the reason. If you do not have a specific time, date or location decided then please estimate these answers to the best of your knowledge.
EVENT SPECIFICS
Event Name: Clunker Series 500
Location of Event: Sandy Shores Airfield
Date of Event: 10/12/2022
Start Time: 19:00
Planned End Time: 22:00
(Mark one of the below options with an X)
- [ ] Confirmed and not subject to change.
- [x] Unconfirmed and may be subject to change.
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<Clunker Series 500 is a fun event for the teams of SAMRA, it's an event where they can let loose and race just for the fun of it and have some friendly competition where they do not lose anything if they do not win. The event is to be hosted on the SAMRA race track taking place on the Sandy shore Airfield, We will have SAMRA staff available on site, and the support of LSGov, Blaine Aviation and SAAA.
A side note of this is that this series may be made public for people to participate in, just like our Open Series events.
..>
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ATTACHMENTS
<Clunker Series 500 is a fun event for the teams of SAMRA, it's an event where they can let loose and race just for the fun of it and have some friendly competition where they do not lose anything if they do not win. The event is to be hosted on the SAMRA race track taking place on the Sandy shore Airfield, We will have SAMRA staff available on site, and the support of LSGov, Blaine Aviation and SAAA.
A side note of this is that this series may be made public for people to participate in, just like our Open Series events.
..>
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REQUEST INFORMATION
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Please fill out this next section in it's entirety. If something cannot be answered, please put N/A or a short explanation depending on the reason.
REQUEST & DOCUMENTATION
What are you requesting?
Please tick as many as are appropriate. If requesting LSFD presence at the event, please indicate if you require a specific type of unit. If you are unsure, please leave blank.
A Special Event Permit is required for all events that take place on public property ((anything that is not held on a script-owned ingame property)). If you require one and have not yet applied, please do so via the LSGOV's online portal.
Dependent on the specifics of the event, official presence by a Law Enforcement Agency may be required a the event. If you require one and have not yet applied, please select a Law Enforcement Agency and file a request via their portal.
Date: 05/12/2022
Signature:
Arianna DeRose
Please fill out this next section in it's entirety. If something cannot be answered, please put N/A or a short explanation depending on the reason.
REQUEST & DOCUMENTATION
What are you requesting?
Please tick as many as are appropriate. If requesting LSFD presence at the event, please indicate if you require a specific type of unit. If you are unsure, please leave blank.
- [x] Event Approval / Fire Safety Certification.
- [ ] LSFD presence at the event. Specific Units Requested:
A Special Event Permit is required for all events that take place on public property ((anything that is not held on a script-owned ingame property)). If you require one and have not yet applied, please do so via the LSGOV's online portal.
- [ ] Yes. Provided copy: Copy of the Event Permit
- [x] No, but I have applied. [b:[/b] 05/12/2022
- [ ] No, does not apply (Private Property)
- [ ] No.
Dependent on the specifics of the event, official presence by a Law Enforcement Agency may be required a the event. If you require one and have not yet applied, please select a Law Enforcement Agency and file a request via their portal.
- [ ] Yes. Provided email: Copy of the confirmation email
- [ ] No, but I have sent a request. Date of Request: DD/MMM/YYYY
- [x] No.
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<Feel free to leave this blank if none.>
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AGREEMENTS
I, the below signed, certify that the information given on this event request form is true and complete to the best of my knowledge. I also agree to comply with the Los Santos Fire Department, agree to all the event requirements and agree to terms as outlined above. I agree that if I fail to comply with the terms established above, I would be subject to a fine issued by the Los Santos Fire Department. I also agree to inform the Los Santos Fire Department of any cancellations or rescheduling and failing to do would mean I would be subject to a fine issued by the Los Santos Fire Department.<Feel free to leave this blank if none.>
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Date: 05/12/2022
Signature:
Arianna DeRose
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