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Competitor Entry Form

Do Not Procede to Scrutineering until all sections of Page 1 are complete

 

RACE NUMBER                               _____________________

(obtained from the tower in unknown)                                          

LICENSE NUMBER                                   _____________________

(DDL obtained from the ticket box if not a current ANDRA license holder)

TDRA Membership Number        _____________________

(obtained from the ticket box if not a current member)

EVENT DATE    _______________________

DRIVER/ RIDER FIRST NAME__________________________________________________________

SURNAME _________________________________________________________________________

ADDRESS _________________________________________________________________________

SUBURB/TOWN _____________________________________________ POST CODE____________

MOBILE NO_________________________EMAIL__________________________________________

VEHICLE TYPE__________________________________________ ENGINE CAPACITY___________

Entry Fees			Total
Competitor Entry		$60	$
ANDRA DDL (if required)		$10	$
TDRA Membership (if required)		$10	$
Pit Crew (max. 4) each		$10	$

 

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EXCLUSION OF LIABILITY, RELEASE AND ASSUMPTION OF RISK - ENTRANTS/DRIVERS/RIDERS

I/We being the entrant/s and/or driver and/or rider, certify that the particulars on the Entry Form are true and correct in every particular, to the best of my/our knowledge and belief.

I/We declare that I/We have read and understood the Supplementary Regulations issued for the event, and agree to be bound by them and the provisions of the Competition Rules of the Australian National Drag Racing Association Inc. (ANDRA). In Exchange for being able to enter, attend or participate in the event I/WE agree:

•  to release ANDRA, promoters, sponsors 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 participation in or attendance at the event, except to the extent prohibited by law;
•  that ANDRA and the Associated Entities do not make any warranty, implied and 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/our own risk.

I/We acknowledge that the risks associated with attending or participating in the event 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 or participating in the event; and
•  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/us.

I/We accept the conditions of, and acknowledge the risks arising from, attending or participating in the event and being provided with the event services by ANDRA and the Associated Entities.

Where the Driver/Rider is under the age of 18 years the following Parent/Guardian Consent must be completed: PARENT/GUARDIAN CONSENT - PERSONS UNDER 18 YEARS OLD.

I __________________________(please print) of (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/participation in the event at his/her own risk.

Parent/Guardian* Signature _________________________________ Date _____/_____/_____

*delete whichever does not apply

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 COMPETITOR DECLARATION

SECTION A

I                                                                                                                                             (please print)of                                                                                                                                                                    hereby state that:

I or my agent have inspected the vehicle against all items ticked in Section B of this form and confirm that the entered vehicle complies with all relevant minimum Safety and Class Eligibility requirements as detailed in the ANDRA Rulebook.  The vehicle will be made available for Compliance Audits as requested by the appointed Officials.

SECTION B

Category One - Safety Critical

	Helmet    Standard:		Steering system		Throttle Return
	Protective Clothing		Suspension system		Fire extinguisher
	Safety Harness   Expiry:		Seat and mountings		Fire System
	Roll over protection		Wheels/Tyres		Braking system
	Bellhousing/Auto Trans Shield
	Current Technical Inspection

 

Category Two - Safety Non Critical

	Engine & Transmission		Fuel tank/lines
	Clutch & Flywheel		Liquid Overflow
	Neutral Safety Switch (auto trans)		Lower Engine Containment Device
	Battery/Battery Mounting		Lubrication & Cooling System
	Battery Isolation Switch		Firewall

 

Category Three - Class Compliance and Non Safety

	Engine capacity & components				Supercharger Overdrive
	Transmission Type				Electronic Devices
	Body Dimensions & Aerodynamics				General Vehicle Presentation
	Fuel Type *				Licence Number & Class display

          X = Not applicable         *Please note Fuel Blend

 

THIS SECTION TO BE SIGNED AT THE EVENT IN FRONT OF AN OFFICIAL

I am aware that where any breach of the Rules and Regulations of ANDRA is found during a Compliance Audit I render myself liable to Tribunal Action and/or appropriate penalties and my signature below indicates my acceptance of this undertaking.

Licence Number                                   Bracket                                          Class                                   

Signature (Driver/Rider)                                                                          Date                                   

 

Witness (Official)                                                                                        (please print)

Signature (Official)                                                           Position                                                       

 

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