I agree that neither Outriders Social Dirtbike Club, nor the promoters, organisers, or sponsors of any event, or the owners of the property on which an event is held, and/or their respective officials, agents, servants or representatives shall be liable under any circumstances for any damage or for any personal injury – fatal or otherwise – or loss of whatever kind sustained by myself or any person whatsoever, while riding or while being present at any event, by whatever means such damage, injury or loss may be caused, and even though the same may have been contributed to or caused by the willful act, neglect or default of any official, agent, servant or representative of Outriders Social Dirtbike Club, or any promoters, organizers, or sponsor s of the event, or owners of the property on which the event is held.

I hereby indemnity Outriders Social Dirtbike Club, the promoters, organisers, and sponsors of the event, and the owners of any property on which the event is held, and their respective officials, agents, servants and representatives against any legal liability for any damage or injury so done or sustained as aforesaid by myself or any other such persons as aforesaid

I further admit and declare that I am fully aware of and appreciate the ambit and extent of the risks, dangers and perils attendant upon being present at or participating in any form of motorsport activity. I hereby voluntarily assume and consent to such risk and the risk of damages arising there from or injury or loss being sustained by myself or any other person as a result thereof.

I further agree that this assumption of and consent to risk shall operate against my dependents and/or heirs, executors and administrators.

I hereby represent to Outriders Social Dirtbike Club and warrant that I am 18 years of age or older, alternatively, if the applicant is under 18 years of age, then the section under Parent/Guardian/Curator must be completed and signed as indicated.

Junior Day Round 1