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
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
1. Federation Internationale Motorcycliste
2. Motorcycling Australia Ltd
3. Motorcycling: Queensland, New South Wales, Victoria, Western Australia, Tasmania, South Australia, Northern territory.
1. Moss Institute Coaching school Schedule
METHOD OF PAYMENT
Moss Institute – National Australia Bank
BSB 082-762 ACCOUNT NUMBER 86-786-3909
You MUST reference transfer with riders surname 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
“Entry forms with out payment will be discarded – please ensure transfer is done at time of entry”