You can always press Enter⏎ to continue
Welcome
Hi there, please fill out and submit this form.
18
Questions
START
1
I agree to the below terms & conditions for this event?
*
This field is required.
Warning: This is an important document, which effects your legal rights and obligations. Read it carefully and do not sign it unless you are satisfied you understand it.
Exemption / Disclaimer Clause
I am aware that observing, learning, training and participating in any motorbike racing, endurance riding otherwise known as Enduro riding, off road motorbike riding on any motor bike being used for or in connection with observing, learning, training and participating in any motorbike racing, endurance riding otherwise known as Enduro riding, off road motor bike riding on any motorbike is a dangerous undertaking and in undertaking such activities do so at my own risk. HEREBY AGREE with the persons, organisations and bodies corporate whose name appear in Schedule 1 (hereinafter called “the organiser”) that I am by this agreement entitled to participate in the motorcycle meeting listed in Schedule 2 (hereinafter called “the meeting”) at the venue listed in Schedule 3 (hereinafter called “the Venue”) on the terms and conditions set out in this document. Acknowledgment of risks, dangers and obligations 2. I acknowledge that motorcycle racing is dangerous and that by engaging in the sport and participation in the meeting I take I am exposed to certain risks and dangers and am under certain obligations as follows : a) That I may be injured, physically or mentally and may be killed; b) That my machinery or equipment may be damaged, lost or destroyed; c) That other competitors may ride dangerously or with lack of skill; d) That track or event conditions may be hazardous and may vary without warning or predictability; e) That organizers, officials, land owners / track operators and any agents or representatives of those in charge of race meetings are frequently obliged to make decisions under pressure of time and/or events; f) That any policy of or in respect of my life or physical or mental health may be avoided; g) That there may be no or inadequate facilities for treatment or transport of me if I am injured; h) That I have an obligation to myself and to others to compete safely and within the rules of this competition. Indemnity given to organisers 3. In consideration of the acceptance of me as an entrant in the race meeting I agree to indemnify the organisers and each of them in the following matter, That I participate in the meeting at my sole risk and responsibility, That I accept the venue as it stands with all and any defects hidden or exposed,That I indemnify and hold harmless the organisers, their respective servants, agents or officials against any actions or claims which may be made by me or on the behalf or by any other parties for or in respect of or arising out of my death or any injury, loss or damage caused to me or my machinery or equipment whether caused by negligence, breach of contract or in any other manner whatsoever. Third Party Indemnity where an entrant is under 18 years of age being the parents or guardians of the person named in clause 1 (hereinafter called “the entrant”)hereby acknowledge. a) That I/We have read the whole document and understood it; b) That I/We consent to the entrant participating in the race meeting; and c) That I/We are aware of the risks, dangers, and obligations set out in Clause 2 hereof 5. In consideration of the entrant being accepted as an entrant in the race meeting, I/We hereby indemnify the organisers in the same manner and to the same effect as if I/We were the entrant. 6. I understand and acknowledge that by being an entrant or being a parent/guardian who has given authority hereunder to an entrant under 18 years of age attending a Tasmanian Endurance Riders Club event, myself, my children or children in my care may be photographed or videoed by other persons attending the event either as participants, members, spectators or officials. I also accept that although The Tasmanian Endurance Riders Club encourages responsible and appropriate use of images, the club cannot control the use or dissemination of images and as such they may be published in the public domain. I am also aware that it is a condition of admission to membership of this event, that this club, its directors, instructors, members, servants or agents are absolved from all liability howsoever arising from injury or damage howsoever caused (whether fatal or otherwise) arising out of membership of this club or participating in observing, learning, training and participating in any motorbike racing, endurance riding otherwise known as Enduro riding, off road motor bike riding on any motor bike, or in any way whatsoever due to any negligent act, breach of duty, default and/or omission on the part of this club, its directors, instructors, members, servants or agents, or on the part of its office bearers, directors and servants and agents. I am also aware that any person observing, learning, training, and participating in any motorbike racing, endurance riding otherwise known as Enduro riding, off road motor bike riding on any motorbike or participating in any activity carried out by this club are only allowed to do so on the distinct understanding that they do so at their own risk.
Yes
Previous
Next
Submit
Press
Enter
2
I have read and understand the TERC rules and agree to abide by our code of conduct
*
This field is required.
Yes
Previous
Next
Submit
Press
Enter
3
Entry is for a TERC Member *if you are not a member please complete your membership here before continuing: https://www.taserc.com/copy-of-want-to-race
*
This field is required.
Yes
No
Previous
Next
Submit
Press
Enter
4
If you are not a member please complete your membership here before continuing:
www.taserc.com
Previous
Next
Submit
Press
Enter
5
Event
*
This field is required.
By entering this event, you will go into the draw to win a CRF 110 Proudly sponsored by City Bike Centre
Loyatea Enduro
Loyatea Enduro
Previous
Next
Submit
Press
Enter
6
I am completing this form
*
This field is required.
For a Junior
Previous
Next
Submit
Press
Enter
7
Full Name Parent/Guardian
First Name
Last Name
Previous
Next
Submit
Press
Enter
8
Phone Number of Parent/Guardian
Previous
Next
Submit
Press
Enter
9
Full Name of Entrant
*
This field is required.
First Name
Last Name
Previous
Next
Submit
Press
Enter
10
Email
*
This field is required.
example@example.com
Previous
Next
Submit
Press
Enter
11
Phone Number
*
This field is required.
Previous
Next
Submit
Press
Enter
12
Do you have any Medical Conditions
*
This field is required.
Yes
No
Previous
Next
Submit
Press
Enter
13
Please advise details of any medical condition(s)
Previous
Next
Submit
Press
Enter
14
Race Number
*
This field is required.
Previous
Next
Submit
Press
Enter
15
Transponder Number
*
This field is required.
If you do not have a transponder please enter a zero, if you do not list your transponder you will not be scored
Previous
Next
Submit
Press
Enter
16
Bike Make, Model,
*
This field is required.
Honda CRF250 VIN#, Yamaha YZF250
Previous
Next
Submit
Press
Enter
17
VIN #
Previous
Next
Submit
Press
Enter
18
Second Bike Make, Model,
Honda CRF250 VIN#, Yamaha YZF250
Previous
Next
Submit
Press
Enter
19
Second Bike VIN #
Previous
Next
Submit
Press
Enter
20
Emergency Contact Name
*
This field is required.
First Name
Last Name
Previous
Next
Submit
Press
Enter
21
Junior Classes
*
This field is required.
PW OPEN
PW A
PW B
PW C
TRAIL C
JUNIOR OPEN A
JUNIOR OPEN B
JUNIOR OPEN C
85 A
85 B
85 C
65 A
65 B
TRAIL A
TRAIL B
TRAIL 115
OFFICAL
SWEEP
Previous
Next
Submit
Press
Enter
22
Entry Fees
*
This field is required.
prev
next
( X )
My Bag
1
My Bag
Back to list
Great Product Name
$20
Quantity:
1
Size:
Small
Remove
Edit
Great Product Name
$20
Quantity:
1
Size:
Small
Remove
Edit
Great Product Name
$20
Quantity:
1
Size:
Small
Remove
Edit
Great Product Name
$20
Quantity:
1
Size:
Small
Remove
Edit
ORDER SUMMARY
Total cost
AUD
JUNIOR - Late Entry Fee
$
60.00
AUD
+
Edit
Back
Previous
Next
Submit
Press
Enter
23
Message or Comments
Previous
Next
Submit
Press
Enter
24
Enter the message as it's shown
*
This field is required.
Previous
Next
Submit
Press
Enter
Should be Empty:
Question Label
1
of
24
See All
Go Back
Submit