Race Entry Form

Racers Details

Full Name*

First NameLast Name

Address*

Street Address

Street Address Line 2

CityState

Post Code

Phone Number*

E-mail

SBA License Number

Codes on License

Boat Name

Boat Type/Reg Number

Class*

	Tick One
Top Fuel Hydro
Top Alcohol Hydro
Top Alcohol Flat
Pro Mod
Bracket 8 Sec
Bracket 9 Sec
Bracket 10 Sec
Bracket 11 Sec
Bracket 12 Sec
Bracket 13 Sec
Bracket 14Sec
Jetski

Medical

	Yes	No
I have a full current medical
Copy APBA
SRA Accepted
I’m prepared to sign a self-medical & accept full responsibility for myself

Cells / Breakaway Capsules / Rope Deflectors

Note: The VDBC will not allow any boat below 8 sec to race unless your boat is fitted with a cell or breakaway capsule, the safety and compliance is the boat owners responsibility to ensure it complies with relevant rules as applicable. It must also pass the diver inspection and relevant air fittings as per the rule book. If your fittings are incorrect you will need to obtain the correct fittings before been allowed to race. This is your responsibility.

All Boats are to be fitted with a rope deflector, without one you cannot race.

Important Information / Declaration

I declare that I am in possession of, or will obtain the current Racing Safety Rules Book and Log book.

I/we will abide by the Rules & Regulations contained therein. I will not do anything that will or may bring drag boat racing into disrepute whilst racing under Victorian drag Boat Club Inc, sanction event or any affiliated or joint event as recognized by any parties.

I declare that I am in possession of a Current State Boating Licence as required by my State Boating Authority and I acknowledge that this application is conditional on compliance with the applicable State Boating Authority requirements.

I declare that boat/vessel entered is a current registered vessel with the relevant state authorities and I acknowledge that this application is conditional on compliance with the applicable State Boating Authority registrations.

I agree that if my membership to the Victorian Drag Boat Club Inc, lapses or is terminated that I will not be allowed to race at any sanction event conducted by the respective club until rectified by me, the applicant.

I have enclosed the prescribed fee and certify that the given particulars herein are true and correct and I will notify the Victorian Drag Boat Club Inc, if any change occurs.

I am fully aware by this application, that making any false declaration, I am liable to refusal or cancellation of entry & memberships issued by the VDBC Inc: I also acknowledge that I may also be liable to State/Territory or Civil Laws outside the control of the VDBC Inc & are to be dealt with at my own personal Costs & Legal Representations.

Signature*