FORM "D" CONSENT AND INDEMNITY FORM

REMINDER -

Due Date for Entry Form A , "TEAM ENTRY AND CLASSIFICATION" is Friday 1 August 1997.

Team Managers please photocopy this page for each team member.

The following form must be completed and signed by parents/ guardians/ caregivers of all participants under 18 years of age before the first race day, 1997.

I, ________________________________, hereby consent to my child/ charge,

(Name of Parent/ Guardian/ Caregiver)

________________________________

(Name of Team Member)

entering the Australian National Pedal Prix Competition and accepting prizes pertaining to it.

I agree to be bound by the rules and expectations of participation in this event, and specifically by the conditions of the entry forms.

I understand that the organisers of this event take no responsibility for loss or damage to property, or for personal injury, and I have read and understood the "Release and Indemnity Clauses 9.1 to 9.9".

I confirm that my child/ charge did contribute to the design and construction of the team vehicle as required on Page 7, Section 2.2

Signature _________________________

Date _________________________

CATEGORIES 1 TO 4

ALL TEAMS MUST COMPLETE MEDICAL DECLARATION FORMS AS REQUIRED FOR SCHOOL EXCURSIONS AND ENSURE THAT TEAM MEMBERS ARE ADEQUATELY COVERED BY APPROPRIATE INSURANCE.

E.G SCHOOL INSURANCE, AMBULANCE COVER.

THESE FORMS MUST BE HELD BY TEAM MANAGERS AND BE AVAILABLE UPON REQUEST.

CATEGORY 4 TEAM MEMBERS ONLY -

PLEASE SIGN FORM "D" AND DATE UPON READING OF RELEASE AND INDEMNITY CLAUSES 9.1 TO 9.9.