TASMANIAN ENDURANCE RIDERS CLUB INC.
INDEMNITY FORM Warning: This is an important document,
which affects your legal rights and obligations. Read it carefully and do
not sign it unless you are satisfied you understand it.
Exemption /
Disclaimer Clause
I * (Full name of rider), Date
of Birth
*
HEREBY AGREE
1. 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.
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.
3.Indemnity given to organisers; 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.
SCHEDULES:
Schedule 1; Tasmanian Endurance Riders
Club of Tasmania Inc. (Land Owner's Name & Address) Beswick Holdings
Rulla Road Sisters
Creek
Schedule 2; Type of Meeting:
Motorcycle Endurance Event (Grass Track)
Schedule 3 ; Race
Venue: Rulla Road Sisters Creek
Date: 11th & 12th September 2010 or 18th &
19th September 2010 (rain date) I AGREE
to the above *
* Insert name or (sign here if
printing)
** This section is only for
third Party Indemnity where an entrant is under 18 years of
age**
being
the parents or guardians of the person
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 AGREE to the above
Date
Insert
Parent/Guardian Name
or ( Sign here if
printing )
7. 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. I, *
Of * DO HEREBY ACKNOWLEDGE I AGREE to the above * *
Date * Paid by Paypal Insert
name or (Sign here
if printing)
