Battle of Jacks Ridge Indmenity 

1. Indemnity:
   I have received the Supplementary Regulations and all other regulations or Articles as determined in the Appendices and Schedules of the current New Zealand Motorsport Manual for the event I am entering and agree to be bound by them and by the National Sporting Code of MotorSport New Zealand Inc.
   In consideration of the acceptance of this entry and of my being permitted to take part in the Meeting or Events detailed, I agree not to pursue claims against and (severally) to hold harmless, indemnify and keep indemnified MotorSport New Zealand Inc, its members, associated or affiliated clubs and entities, rally and/or event organisers and promoters, the inviting club and entity (or entities), race circuit owners, providers and operators, owners and tenants of private property (including land, buildings and/or fixtures, fittings and chattels) traversed, or proximate to events, officials, fellow competitors, and the directors, officers, servants, representatives and agents of those entities (all together “the Indemnified Parties”) in relation to all losses, actions, expenses, costs, liabilities, claims and demands in respect of death, injury, loss or damage to persons or property of myself, and/or my team (including drivers, co-drivers, passengers, management and/or mechanics) whatsoever, caused or arising out of or in connection with this entry or taking part in the events to which this entry relates, notwithstanding that such death, injury, loss or damage may have been contributed to or caused by the negligence of any of the Indemnified Parties and/or by any other person. This provision confers a benefit on, and is intended to be enforceable by, each of the Indemnified Parties (in accordance with the Contracts (Privity) Act 1982).
2. Ability to Control a Vehicle Declaration by Driver:
   I declare that should I at the time of any event this entry form relates to be suffering from any disability of any kind whether permanent or temporary which is likely to detrimentally affect my control of my automobile or my fitness to drive, I will not participate.
3. Vehicle Conformance with Schedule A/AA Declaration by Driver:
   I declare the vehicle detailed on this entry form complies with the vehicle safety items set out below (as applicable) and will be presented on request to an appointed Scrutineer or Technical Officer complying at all times with the safety and eligibility requirements detailed in the National Sporting Code and its Appendices and Schedules.
   Critical Safety Non-Critical Safety Non Safety
   • Helmet
   • Head & Neck Restraint
   • Protective Clothing
   • Safety Harness
   • Window Net(s)
   • Roll Bar / Safety Cage
   • Seat(s) and Mounts
   • Fire Extinguisher
   • Wheels and Tyres
   • Brake System
   • Steering & Suspension Systems
   • Fuel Tank(s) / Fillers / Lines
   • Fuel / Oil / Brake Line Protection
   • First Aid Kit / Safety Triangle • Engine & Transmission Mounts
   • Flexible Fluid Lines & Hoses
   • Throttle Return (Failsafe)
   • Engine Starter Operation
   • Reverse Gear Operation
   • Exhaust System
   • Oil Catch Tank(s)
   • Electrical Wiring
   • Ignition / Circuit Breaker
   • Battery
   • Lighting Systems
   • Brake Lights
   • Rear Lights • Bodyshell / Chassis Condition
   • Exterior Appearance
   • Panels / Covers
   • Doors
   • Windows
   • Wipers & Demisting
   • Rear Vision Mirrors
   • Aerofoils & Spoilers
   • Cockpit Construction / Fittings
   • Bulkheads
   • Tow Eyes
   • Mudflaps
   • Tow Rope
   • Auxiliary Lights • Ballast (Security)
   • Competition Numbers
   • Registration & WOF Labels
   • LVV / MSNZ Authority Card
   • LVV Plate
   • Optional Equipment
   • Restrictor Fitment (36mm ID)
   I acknowledge that where any breach of the Safety Schedule is found during a Safety Audit I will be subject to penalties under the National Sporting Code and my signature below indicates my acceptance of this undertaking.
4. Consent:
   By electronically acknowledging the indemnity as part of my entry form, I consent to the details contained on this form being held by Rally New Zealand Ltd and/or the Inviting Clubs for the purpose of the promotion and benefit of the Rally Event(s) concerned, and Motorsport in general. I acknowledge my right to access and correction of this information. This consent is given in accordance with the Privacy Act 1993.

I also authorise the medical providers of the event to disclose medical information relevant to injury or illness sustained during the above mentioned event to MotorSport NZ and its officials

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