Passenger Indemnity: 4 & Rotary Nationals

Please fill out this form if you wish to be a passenger during one of the DYM (Drive Your Mates) Sessions at the 4 & Rotary Nationals.

Passengers will be required to make a $5 donation on the day to pick up their passenger wristband.
YOUR DETAILS

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NEXT OF KIN DETAILS (IN EVENT OF AN ACCIDENT)

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In consideration of being granted access to a track at the 4 & Rotary Nationals, I irrevocably waive all and any rights I may have against 4 & Rotary Promotions or any of its officers, employees, agents, contractors, or hirers arising in respect of any cost, claim. Loss, damage or injury suffered or incurred by me while I a driver or rider of, or a passenger in or on, a vehicle on a track.

I agree to irrevocably indemnify and save harmless 4 & Rotary Promotions and its officers, employees, agents, contractors, or hirers from and against all and any costs, claims, losses or damages suffered or incurred by 4 & Rotary Promotions or any of its officers, employees, agents, contractors, or hirers directly or indirectly or as a result or consequence of any claim made or proceedings threatened or commenced by any person, firm, or other entity whomsoever or whatsoever arising out of my driving or riding, or being a passenger in or on, a vehicle on a track, whether resulting from any act or omission on the part of 4NR or not.

I agree that this waiver and indemnity shall bind my personal representatives and assignees, and my trustees, executors or administrators.

I agree to comply with the Rules of 4 & Rotary Promotions at all times and with all directions and instructions given to me by any officer or official having or appearing to have authority to act in respect of 4 & Rotary Promotions or the event being held there.
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