MMRC - Competitor Sign on and Waiver

Competitor Sign on and Waiver
Permit Number
Event Start Date

DayMonthYear
Date
Event End Date

DayMonthYear
Date
Competitor Details
ENTRANTS Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState

Postcode
Mobile Number*
Date of Birth*

DayMonthYear
Date
Current Date

DayMonthYear
Date
Age
Email*
example@example.com

Waiver of Liability
AUSTRALIAN AUTO-SPORT ALLIANCE Pty. Ltd.
79 Rowan Street Wangaratta Vic 3677
RELEASE AND WAIVER OF LIABILITY
ASSUMPTION OF RISK AND INDEMNITY AGREEMENT
WARNING! Motor Racing is Dangerous and accidents can and do happen. All care is taken toprotect you but you are warned that there is a possibility of an accident causing injury, death orproperty damage.
Subject to that warranty, if applicable and IN CONSIDERATION of being permitted to compete, officiate, observe, work for, or participate in
any way in the EVENT(S) or being permitted to enter for any purpose any RESTRICTED AREA (defined as any area requiring special
authorization, credentials, or permission to enter any area to which admission by the general public is restricted or prohibited), EACH OF THE
UNDERSIGNED, for himself/herself, his/her personal representatives, heirs and next of kin.
1. Acknowledges, agrees and represents that he/she enters and he/she further agrees and warrants that, if at any time, he/she is in or about
RESTRICTED AREAS and he/she feels anything to be unsafe, he/she will immediately advise the officials of such and will leave the
RESTRICTED AREAS and/or refuse to participate further in the EVENT(S).
2. HEREBY RELEASES, WAIVES, DISCHARGES AND COVENANTS NOT TO SUE Australian Auto-Sport Alliance Pty. Ltd., the
landowners, promoters, participants, racing associations, sanctioning organizations or any subdivision thereof, track operators, officials,
car owners, drivers, pit crews, rescue personnel, any persons in any RESTRICTED AREA, promoters, sponsors, advertisers, owners and
lessees of premises used to conduct the EVENT(S), premises and event inspectors, surveyors, underwriters, consultants and others who
give recommendations, directions or instructions or engage in risk evaluation or loss control activities regarding the premises or EVENT(S)
and each of them, their directors, officers, agents and employees, all for the purposes as herein referred to as “Releases”, FROM ALL
LIABILITY, TO THE UNDERSIGNED, his/her personal ON ACCOUNT OF INJURY TO THE PERSON OR PROPERTY OR
RESULTING IN DEATH OF THE UNDERSIGNED ARISING OUT OR RELATED TO THE EVENT(S), WHETHER CAUSED BY
THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE.
3. HEREBY AGREES TO INDEMNIFY AND SAVE AND HOLD HARMLESS the Releases and each of them FROM ANY LOSS,
LIABILITY, DAMAGE OR COST they may incur arising out of or related to the EVENT(S) WHETHER CAUSED BY THE
NEGLIGENCE OF THE RELEASEES OR OTHERWISE.
4. HEREBY ASSUMES FULL RESPONSIBILITY FOR ANY RISK OF BODILY INJURY, DEATH OR PROPERTY DAMAGE arising
out of or related to the EVENT(S) whether caused by the NEGLIGENCE OF RELEASEES or otherwise.
5. HEREBY acknowledges that THE ACTIVITIES OF THE EVENT(S) ARE VERY DANGEROUS and involve the risk of serious injury
and/or death and/or property damage. Each of the UNDERSIGNED also expressly acknowledges that INJURIES RECEIVED MAY BE
COMPOUNDED OR INCREASED BY NEGLIGENT RESCUE OPERATIONS OR PROCEDURES OF THE RELEASEES.
6. Hereby assumes full responsibility for the preparation and safety of the vehicle to be used and further give an assurance that the vehicle has
been checked for safety and is in a condition fit to be used for motor racing.
7. Hereby agrees that this Release and Waiver of Liability, Assumption of risk and Indemnity Agreement extends to all acts of negligence by
the Releases, INCLUDING NEGLIGENT RESCUE OPERATIONS and is intended to be as broad and inclusive as is permitted by the laws
of the State/Territory in which the Event(S) is/are conducted and that if any portion thereof is held invalid, it is agreed that the balance
shall, notwithstanding, continue in full legal force and effect
Is this entrants over 18 years of age?*
I (Entrant) HAVE READ THIS RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK AND INDEMNITY AGREEMENT, FULLYUNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND HAVESIGNED IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT, ASSURANCE OR GUARANTEE BEING MADE TO MEAND INTEND MY SIGNATURE TO BE A COMPLETE AND UNCONDITIONAL RELEASE OF ALL LIABILITY TO THE GREATESTEXTENT ALLOWED BY LAW.

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I (parent or guardian Name)
parent / guardian of the child listed above
Signature ----- I being the parent / guardian of the child listed above have read the whole of this document and consent to him / her participating. In doing so, I acknowledge that Motor Sport is dangerous, and agree that neither Australian Auto-Sport Alliance Pty. Ltd. nor “the organisers” shall be under any liability whatsoever for any death or bodily injury, loss or damage which may be sustained or incurred by the above named minor, or by me, howsoever such death or bodily injury, loss or damage is caused by negligence or otherwise.

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Signed this day of

DayMonthYear
What is your membership status?
Full Member Track Fees
Social/Non Member Track Fees
Are you Driving a Shared mower?*
Total Track Fees
Should be Empty:

Competitor Sign on and Waiver

Competitor Details

Waiver of Liability