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P O BOX 6747 BLACKTOWN DELIVERY CENTRE NSW 2148 PHONE: 02 9672 1000 FAX: 02 9672 0209

AUSTRALIAN RACING DRIVERS CLUB LTD

Website: www.sydneymotorsportpark.com.au

ABN: 85 000 110 609

DISCLAIMER
EXCLUSION OF LIABILITY, RELEASE AND ASSUMPTION OF RISK

PRIVATE PRACTICE
I apply to Australian Racing Drivers Club Limited (ARDC) (Track Operator) for permission to enter and use the property known as the Sydney Motorsport Park motor sport circuit (Circuit) for the purpose of driving a car or driving a superkart in Private Practice/Testing sessions conducted at the Circuit and also for the purpose of taking part as an official, spectator or mechanic in connection with Private Practice/Testing (Activity). In exchange for being able to attend the Circuit and participate in the Activity (whether as a driver, official, spectator or mechanic), I agree: To release Confederation of Australian Motor Sport Ltd (CAMS) and Australian Motor Sport Commission Ltd, promoters, sponsor organisations, land owners and lessees, organisers of the event, 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 in the Activity, except to the extent prohibited by law; that CAMS 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 which they are supplied; indemnify, and keep indemnified, the Track Operator, CAMS and the Associated Entities in respect of any actions, suits, proceedings, claims, demands, losses, damages, costs, penalties and fines as a result of or in connection with the Activity whether caused or contributed to by any act or omission (including negligence) of the Track Operator, CAMS or the Associated Entities; and to attend the Circuit or participate in the Activity at my own risk.

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 of facilities (including grandstands, fences and guard rails) to ensure the safety of persons or property at the Circuit.

motor sport is dangerous and that accidents causing harm can and do happen and may happen to me.
Please see over

I accept the conditions of, and acknowledge the risks arising from, attending the Circuit or participating in the Activity and being provided with the Activity services by CAMS and the Associated Entities. Private Practice Date: ___________________ ARDC Membership No: _________________ Car Club if Not ARDC Member: ________________________ D.O.B: ________________________ Expires: _______________________

Driver / Entrant: ______________________________________________ Private Practice CAMS /MA Licence No: ______________________

Address: ________________________________________________________________________________________ Tel (wk): _______________________ Tel (hm): _______________________ Mob: __________________________

Email: _________________________________________________________ Emergency Contact Name: ___________________________________ Car / Bike Year: ______________________ Emergency No: ____________________ Car/ Bike Model: ____________________

Car/ Bike Make: _______________________

I________________________________________ being the bona fide owner of the vehicle described on this form hereby declare that: a) The vehicle and all related equipment and components necessary for participation in this event shall be presented, at all times and in every respect, in a condition suitable for use in this activity. b) I have caused the vehicle to be inspected and that it is free from mechanical defects, be they of design or structural integrity, that may render the vehicle unsafe for activity. c) I have been fully briefed on all aspects of the operation of the vehicle, including peculiarities relating to its handling and performance during competition, and d) My competition apparel, including helmet and any HANS device is in compliance with Schedule D.

Driver Signature: _______________________________________

Date: ____________________

Credit Card Payment (We do not accept AMEX or DINERS) I authorise the ARDC to debit my Mastercard/Visa credit card for the amount of $______________ Card Holders Name: ___________________________________________________________________________________ Card No: ____ ____ ____ ____ / ____ ____ ____ ___ / ____ ____ ____ ___ / ____ ____ ____ ___ Expiry Date: _______/_______
Office Use Only Track Operator: ________________ Date: ________________ $ .
Cash / Cheque / Visa / Mastercard / Eftpos

Signature of Card Holder: ________________________________________________

-----------------------------------------------------------------------------------------------------------------------------------------------------For persons under the age of 18 years the following parent/guardian consent must be completed:

PARENT/GUARDIAN CONSENT PERSONS UNDER 18 YEARS OLD


I .... of ......
[Name] [Address]

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. Signed: .. [Parent/Guardian*] * delete whichever does not apply Date: .....

----------------------------------------------------------------------------------------------------------------------Tax Invoice and Receipt for Private Practice / Track Day at Sydney Motorsport Park held on ... / /..
Received from . in the sum of $ paid by cash / cheque / credit / eftpos (includes 10% GST)

Signed ..