Before you and/or your dependants participate in any activities offered by Stellantis South Africa Proprietary Limited (hereinafter collectively referred to as “Stellantis SA”), there are important safety measures which you must understand. Please read this form carefully, as it concerns your safety and that of your dependants, and then sign the indemnity form.
The activities offered by Stellantis SA can be hazardous to your health and/or dangerous and:
- you should you be suffering from any medical condition which would make it unwise for you to participate in the activities, please refrain from doing so. If you are unsure as to whether you or your dependants should be participating, please DO NOT ask Stellantis SA staff, agents, instructors or designated drivers for advice as they are not medical doctors and cannot advise you. Please contact your GP for advice.
By signing this form, you declare that:
- You are not aware of any medical conditions that would make it dangerous for you or your dependants to participate in the activities offered by Stellantis SA;
- You are not intoxicated or under the influence of drugs which could compromise your safety and the safety of those around you;
- You and your dependants understand that the activities offered by Stellantis SA may be inherently dangerous ad may create certain risks to persons that can result in serious physical injury (including the aggravation, acceleration or recurrence of such an injury) and/or damage to property;
- You have out of your own free will chose to take part in the activities offered by Stellantis SA;
- You and your dependants are in a fit state of mental and physical health to withstand all of the physical conditions and risks associated with participating in the activities;
- You and your dependants will comply with the instructor’s/designated driver’s instructions as well as the instructions contained on the various health and safety boards.
- You agree to the processing of your Personal Information as well as that of your dependants;
- You indemnify and hold harmless Stellantis SA, its directors, staff, agents, instructors or designated drivers (including any parent company, subsidiaries, affiliates, successors or assigns) from any and all claims of whatsoever nature which I or my dependants may suffer as a result of being injured or suffering loss or damage to property whilst participating in the activities offered by Stellantis SA whether such claims arise in consequence of an act or omission and whether such act or omission was negligent or not