Officials Sign On Sheet

In exchange for being able to attend or participate in the Event, I agree:

to release Australian Auto-Sport Alliance Pty. 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 or personal injury (including burns and psychological trauma) howsoever arising from my participation in or attendance at the Event, except to the extent prohibited by law;
that Australian Auto-Sport Alliance Pty. Ltd. and the Associated Entities do not make any warranty, implied or express, that the Event 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; and
to attend or participate in the Event at my own risk.

COMMUNICABLE DISEASE EXCLUSION

Notwithstanding any provision to the contrary within this policy, this policy does not cover all actual or alleged loss, liability, damage, compensation, injury, sickness, disease, death, medical payment, defence cost, cost, expense or any other amount, directly or indirectly and regardless of any other cause contributing concurrently or in any sequence, originating from, caused by, arising out of, contributed to by, resulting from, or otherwise in connection with a Communicable Disease or the fear or threat (whether actual or perceived) of a Communicable Disease.
For the purposes of this endorsement, loss, liability, damage, compensation, injury, sickness, disease, death, medical payment, defence cost, cost, expense or any other amount, includes, but is not limited to, any cost to clean-up, detoxify, remove, monitor or test for a Communicable Disease.
As used herein, a Communicable Disease means any disease which can be transmitted by means of any substance or agent from any organism to another organism where:
1. the substance or agent includes, but is not limited to, a virus, bacterium, parasite or other organism or any variation thereof, whether deemed living or not, and
2. the method of transmission, whether direct or indirect, includes but is not limited to, airborne transmission, bodily fluid transmission, transmission from or to any surface or object, solid, liquid
  or gas or between organisms, and
3. the disease, substance or agent can cause or threaten bodily injury, illness, emotional distress, damage to human health, human welfare or property damage.

I acknowledge that:

the risks associated with attending or participating in the Event include the risk that I may suffer harm as a result of:
1. motor vehicles (or parts of them) colliding with other motor vehicles, persons or property.
2. acts of violence and other harmful acts (whether intentional or inadvertent) committed by persons attending or participating in the Event; and
3. the failure or unsuitability of facilities (including grand-stands, fences and guard rails) to ensure the safety of persons or property at the Event.
motor sport is dangerous and that accidents causing harm can and do happen and may happen to me.

First Name *

Last Name *

Officials Licence Number *

Phone Number *

Email Address *

Official Duty *

WWCC NO *

EXPIRY DATE *

Date of Event

Time of Arrival

Hours

Minutes

Officials Sign On Sheet

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