ࡱ> oqn bjbj 4z  8=<yDh $"b33H  Ai@A*Y^0a""i"i>,$B33d" : ENTRY FORM PHOTORACE LEGENDS,2009 23rd/24th May, 2009. Kharghar, Navi MumbaiOrganised By: Indian Automotive Racing Club41-43, Liberty Bldg., New Marine Lines, Mumbai-400020.Promoted By: A R MotosportPlease fill in with typewriter or write in block letters.For each class driven, separate entry forms to be filled.For Entry fees see details on next page. NO ENTRIES WILL BE ACCPETED AFTER 20.05.09 17.30 Hrs. 1. ENTRANT/COMPETITORFull name:Blood GroupAddress: Telephone : MobileRes:Off:TelephoneE-mail2. DETAILS OF THE VEHICLE (All details are compulsory)MakeModelColourC.C. Participating Class/Category with Code : (e.g. Indian Pro stock Car from 1451 to 1650 cc: B3 ) Engine No.Chassis No.Insured byValid tillSp. Rally CoverRegn. No.Sign of Entrant/CompetitorName and Sign of Witness The entry form will be accepted only if all details are duly filled and accompanied by the following documents:1. Copy of Car/Bike RC book2. Copy of Personal Accident Insurance Policy of Rs 2,00,000 valid for Motor sports for DATES OF EVENT 3. 2 Passport size photographs of the competitor.4. Copy of Driving License5. FMSCI competition license (Application forms available with the organizers)6. Authority Letter from Owber if the vehicle is not on driver/riders name.7. Indemnity Form duly signed.8. 1 passport size photograph of Pit Mechanic. 9. Entry fees Amount Rs. By Cash/ DD No. Dt: The Demand Draft for entry fees in favour of Race Legends Payable at Mumbai. Standard entry fees for Indian Bikes Rs.3,500/= per class driven. Standard entry fees for Foreign Bikes Rs.5,000/= per class driven. Standard entry fees for Indian/Foreign Cars Rs.5,000/= per class driven. Standard entry fees applicable when entry form is receive by IARC before normal closing of entries date. (i.e. Tuesday, 19.05.09 17.30 Hrs) A LATE ENTRY FEE of Rs 5,000/- will be charged for entries received within 24 hrs of the normal closing date/time of entries mentioned in the Official Programme. (i.e. from Tuesday, 19.05.09 till Wednesday 20.05.09 17.30 Hrs) INDEMNITY FORM FOR ALL APPLICANTSThe following indemnity must be completed by the parent or legal guardian of applicants under 18 years of age, by the applicant if above 18 years and by the Corporate / Legal Entity. RACE LEGENDS,2009 23rd/24th May,2009. PARITICPANTS INDEMNITY THE FOLLOWING MUST BE COMPLETED BY ALL PARTICIPANTS: I, __________________________________________ of __________________________________ (Full name of Applicant/Parent/Legal Guardian/Legal Entity) (Address) ------------------------------------------------------- THE FOLLOWING MUST BE COMPLETED BY PARENT/GAURDIAN IF APPLICANT IS UNDER 18 YEARS OF AGE This is to certify that I, the undersigned, submit this application to take part in the Event . I hereby agree to indemnify the associations known as the FIA, CIK, FIM, FMSCI (Federation of Motor Sports Clubs of India ,IARC(Indian Automotive Racing Club), its affiliated clubs, all sponsors, event managers and all or any members, officials or assistants of any of the above named and/or known organisations against injury or accident to myself or damage to my equipment, whether in practice or competition. I undertake to be bound by the rules issued by the FMSCI now and in the future, to the International Sporting Code of the FIA and to any Supplementary Regulations that apply. I certify that the information contained on this form is, to the best of my knowledge and belief, true, complete and correct in every particular.. I DO HEREBY FURTHER AGREE to keep save harmless and keep indemnified the Central and State Governments, the organisers and their respective officials, representatives, sponsors, employees, agents and all persons assisting them in this event from and against all actions, claims, cost, expenses and demands - Arising out of any failure to observe the International Sporting Code of the FIA or any regulations laid down by the FMSCI or any conditions or amendments thereto or the provision of the Supplementary Regulations of any event for which the Applicant may enter or be entered. In respect of death, injury, loss of or damage to any property if any or otherwise howsoever and not withstanding that the same may have been contributed to or occasioned by the negligence of the organisers and their officials, agents, representative, employees and all other persons assisting them in this event. DATED: SIGNATUREOF APPLICANT: . 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