Dirt Day disclaimer

Dirt Day Disclaimer

EXCLUSION OF LIABILITY, RELEASE AND ASSUMPTION OF RISK FOR DRIVERS
Name*

First NameLast Name
Email*
example@example.com
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Licence Number*
Entrant type*

DriverPassenger
Date of event*

DayMonthYear
Date
I, the {name}, of my own free will hereby apply to WRX Club of QLD (the “Track Operator”) for permission to use the property known as Lease A, Willowbank
Motorsport Precinct (the Circuit”) for the purpose of driving a car in the Dirt Day (the “Activity”).

In exchange for being able to attend the Circuit and
participate in the Activity as a driver, I agree:

• to release the Track Operator, promoters, sponsor organisations, land owners and
lessees, organisers of the Activity, their respective servants, officials, representatives
and agents (collectively, the “Associated Entities”) from all liability for my death,
personal injury (including burns), psychological trauma, loss or damage (including property damage) (“harm”) howsoever arising from my attendance at the Circuit and participation inthe Activity;
• that the Track Operator and the Associated Entities do not make any warranty, implied or express, that the Activity services will be provided with due care and skill or that any materials provided in connection with the services will be fit for the purpose for whichthey are supplied;
• to indemnify the Track Operator and the Associated Entities in respect of any actions, suits, proceedings, claims, demands, losses, damages costs, penalties and fines as a resultof or in connection with the Activity whether caused or contributed to by any act or omission (including negligence) of the Track Operator or the Associated Entities;
• to attend the Circuit or participate in theActivity at my own risk; and
• abide by the Rules in my capacity as a driver.

I acknowledge that:
• the risks associated with attending the Circuit or participating in the Activity include the risk that I may suffer harm as a result of:
• motor vehicles (or parts of them) colliding with other motor vehicles, persons or property;
• acts of violence and other harmful acts (whether intentional or inadvertent) committed by persons attending the Circuit or participating in the Activity; and
• the failure or unsuitability offacilities (including grand-stands, fences and guard rails) to ensure the safety of persons or property at the Circuit.
• Motorsport is dangerous and that accidents causing harm can and do happen and may happen to me. I accept the conditions of and acknowledge the risks
arising from attending the Circuit and being provided with the activity services by the Track Operator and the Associated Entities.
Parent / Guardian under 18 declaration

i blanksOf the following address blank am the parent/guardian* of the above named (“the minor”) who is under 18 years old. I have read this document and understand its contents, including the exclusion of liability and assumption of risk, and have explained the contents to the minor. I consent to the minor attending the Circuit/participating in the Activity at his/her own risk.
Signature*

Clear
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Entry type
prevnext( X )
Member entryIncluded: 1 Driver Entry , 1 Passenger Entry, Membership required and checked on the day
$125.00AUD Quantity



Non member EntryIncluded: 1 Driver entry
$150.00AUD



Non member Passenger entryIncluded: 1 Passenger entry
$20.00AUD Quantity



Total

$0.00AUD
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Dirt Day Disclaimer