• I, being the parent or guardian of the person named in this application, hereby acknowledge:
• I have read, understood and agree with the Victorian Speedway Council Inc. Terms and Conditions, Release and Indemnity, Warning and Acknowledgement of Risks, and Dangers;
• That I consent to the entrant participating in the sport.
• That I am aware of the risks dangers and obligations set out below.
• In consideration of the applicant being issued with a licence, I hereby indemnify Victorian Speedway Council Inc. in the same manner and to the same effect as if I were the applicant and confirm that the details given are correct to the best of my knowledge.

• I hereby certify that I am a current member of a civil ambulance service/ hold a current healthcare/pension card or have private health insurance which includes Ambulance cover.
• I agree to be bound by the Rules, Regulations, Specifications, Model Rules and By-laws of the Victorian Speedway Council Inc. Hereinafter referred to as VSC Inc.
• I authorise St. John Ambulance, or other first aid services, to release to VSC Inc. details regarding injuries sustained by me at an authorised event.
• That I am not receiving payment under Workcover, other Compensation schemes or from an accident insurance policy unless clearance to race is provided.
  If any of the above circumstances change then you must notify the State Office immediately.
• I agree that the State Office can release my name, address etc. to clubs for the purpose of nominations.
• I shall accept the decision of the VSC Inc. in any dispute under the control of the VSC Inc.
• That the VSC Inc. accepts no liability for the conduct of any non-approved/non-permitted event and will not be liable to any person injured as a result of their participation or attendance at any non-approved event. Any personal accident cover arranged by VSC Inc. for and on behalf of drivers/pit crew does not extend to cover any loss or injury suffered at non-approved VSC Inc. events.

* I declare that I am medically & physically fit & free from impairment & able to participate in Speedway Activities. I have undertaken or will undertake all necessary medical and/or fitness assessments & examinations required.

* I have read, understood and agree with and acknowledge by submitting this application the VSC Terms and Conditions, Release and Indemnity, Warning and Acknowledgement of Risks, and Dangers; that I assume with full knowledge of the dangers in my participation in speedway activities and do so at my own risk.