SHANNONS Invite you to enter the

Shannons Show & Shine

Vehicle Show at the

PITTSWORTH SPRINTS

SUNDAY 2nd SEPTEMBER 2018

Start 9am Judging 1pm Gold Coin Entry (Personal gate entry fee $10)

All vehicle show entrants will be given one parade lap of the Sprint track

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Official Vehicle Show Entry Form

PLEASE PRINT CLEARLYENTRANT (CAR OWNER) Name: ____________________________________________________________________________________________________________________

E-Mail Address: ____________________________________________________________________________________________________________ Postal Address:___________________________________________________________________________________________Postcode__________ Phone Number: _____________________________A/Hours Number ______________________________Mobile____________________________ Club __________________________________________________________________________________________

DESCRIPTION OF CARMake Model Year Body Type

Capacity in CC Colour Registration No. Modified Non Modified

DISCLAIMER

EXCLUSION OF LIABILITY, RELEASE AND ASSUMPTION OF RISK – ENTRANTS AND/OR DRIVERS

For entrants – (I/we being the entrant/s of the vehicle described on this Entry Form wish to enter that vehicle for the above event). For entrants and Drivers – I/we being the entrant/s and/or driver, certify that the particulars on this form are true and correct in every particular, to the best of my/our knowledge and belief. In exchange for being able to attend or participate in the event (including entering the event(, I agree: . to release CAMS and Australian Motor Sport Commission 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 any death, personal injury (including burns), psychological trauma, loss or damage (including property damage) (“harm”) howsoever from my participation in or attendance at the event, except prohibited by law;

. that CAMS and the Associated Entities does 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 fir for the purpose for which they are supplied, and to attend or participate in the event at my own risk.

I accept the conditions of, and acknowledge the risks arising from, attending or participating in the event and being provided with the event services by CAMS and the Associated Entities. Entrants Signature ______________________________________________ Date: _____________________________________

ENTRANS/DRIVER/CREW UNDERSTANDING I/we being Entrant/Driver Crew/Official of the vehicle described on this entry form wish to enter the said vehicle for the above meeting. I/We certify that the particulars on this form are true and correct in every particular, to the best of my/our knowledge and belief. I/we also acknowledge and agree as a condition of entry that neither CAMS, nor the Promoters nor the sponsor organisations, nor the land owners or lessees, nor the Organisers of the event, or their respective servants, officials, representatives or agents (all of whom shall collectively be called the organisers) shall be under any liability for my/our death or a bodily injury, loss or damage which may be sustained or incurred by me/us as a result of participation in or being present at the event. Entrants Signature ____________________________________

Please return ASAPRETURN TO:

Pittsworth Sprints34 Helens St. Pittsworth Qld. 4356

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