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Entry form

Sign on 8.30am for a start at 9am through to about 4pm each day

Please fill out the integrated online entry form or download a copy and email it directly back to us – payments can be made by credit card or direct transfer. Once you have completed the entry form you will receive email confirmation of your payment and final instructions. Fees vary for each school and are listed under the information for each school.
STUDENT DETAILS
MA Licence Number*
DOB*

FEES

COACHING 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.
1.CONTRACT TO PARTICIPATE IN MOTORCYCLE SPORTING EVENT AND/OR ACTIVITY

I hereby agree with the persons, organizations and bodies corporate whose names appear in the Schedule 1 (hereafter collectively called “the organizer”) that I am by this agreement entitled to participate in the motorcycle activity / 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.

2.ACKNOWLEDGEMENT OF RISKS, DANGERS AND OBLIGATIONS

I acknowledge that motorcycling sport is dangerous and that by engaging in the sport and participating in this meeting I take and am exposed to certain risks and dangers and am under certain obligations as follows;

  • a) That I may be injured, physically or mentally, and maay be killed
  • b) That my machinery or equipment may be damaged, lost or destroyed;
  • c) That other riders 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 organisers, officials, landowners/track operators and any agents or representatives of those in charge of meetings are
    frequently obliged to make decisions under pressure of time and/or events;
  • f) That any policy of insurance 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 meeting
3.INDEMNITY GIVEN TO ORGANISERS

In consideration of the acceptance of me as an entrant in this meeting I AGREE TO INDEMNIFY the organisers and each of them in the following manner;

  • a) That I participate in this meeting at my sole risk and responsibility;
  • b) That I accept the venue as it stands with all or any defects hidden or exposed;
  • c) 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 mybehalf or by other parties for or in respect of or arising out of my death or any injury loss or damage caused to me or to my machinery or equipmentwhether caused bynegligence, breach of contract or in any other manner whatsoever.
  • d) Right to Use Image: I acknowledge and consent to photographs and electronic images (including, but not limited to, moving images) being taken of me
    during my participation in the Event. I acknowledge and agree that such photographs and electronic images are owned by Moss Institute and it may use the
    photographs and electronic images for promotional or other purposes without my further consent being necessary. Further, I consent to Moss
4.MEDICAL

I declare that I am medically and physically fit and able to participate in Motorcycling Activities.
I acknowledge and agree that if required, the Motorcycling Organisations (or any of them) may arrange medical or hospital treatment (including
ambulance transportation) for me

I authorise such actions being taken by the Motorcycling Organisations and agree to meet all costs associated with such action. Should I receive medical advice or treatment during a Motorcycling Activity, including at the Medical Centre, I hereby consent to the relevant information being disclosed to the relevant Motorcycling Organisations (including without limitation the Chief Medical Officer) and to ensure my ongoing care and in the interest of public safety at the Motorcycling Activity. I understand that I may gain access to my medical information held by Motorcycling Organisations, by contacting my SCB

5.SCHEDULES

Schedule 1
1. Federation Internationale Motorcycliste
2. Motorcycling Australia Ltd
3. Motorcycling: Queensland, New South Wales, Victoria, Western Australia, Tasmania, South Australia, Northern territory.
Schedule 2
1. Moss Institute Coaching school Schedule
Schedule 3
1.

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.

Please note paid entries are NON refundable unless a medical certificate is produced at least 14 days before the school.
In which case a credit will be issued Schools maybe postponed due to weather postponement date will be offered or a credit
voucher

Date*
* By ticking this box you agree to the above terms and conditions and acknowledge this is an electronic signature. If rider is under 18 years of age a parent or legal guardian MUST sign this form

METHOD OF PAYMENT

Credit Card Payment

Exp date
*
*
2% Credit Card Fee will be added to this total

Please note paid entries are NON refundable unless a medical certificate is produced at least 14 days before the school. In which case a credit
will be issued Schools maybe postponed due to weather postponement date will be offered or a credit voucher

Electronic transfer

Moss Institute – National Australia Bank

BSB 082-762    ACCOUNT NUMBER 86-786-3909
You MUST reference transfer with riders sirname and location of school eg. Smith Oakdale and fax or
post transfer confirmation with entry form.
Money order or cheque. Please make cheques or money orders payable to: Moss Institute

* Required fields