2003 RELEASE &
ENROLMENT APPLICATION
Date
Date
I, the undersigned, certify that the name and address listed are correct.
PLEASE PRINT CLEARLY
Name
Age
Address
State
P/code
PLEASE COMPLETE NEXT PAGE ......
Daytime Phone
Date of Birth
(if racer is under 18 yrs)
Racer's Signature
Guardian's Signature
In consideration of being permitted to participate in the Suzuki Contingency Program during the 2003 season, I
(PRINT NAME) _____________________________________ for myself, my successors, heirs and assigns,
release and forever discharge Suzuki Australia Pty Ltd ("SAPL") and its affiliates, agents, employees, servants,
officers, directors, and authorised SUZUKI dealers ("related parties") from all claims, actions or judgements I may
have or claim to have against SAPL and related parties. I agree that I am responsible for all personal injuries,
including death, and injuries to property, real or personal, caused by or arising out of my participation on the Suzuki
Team Support contingency program for 2003.
I further agree for myself, my heirs and assigns to indemnify and hold SAPL and related parties harmless from all
claims and suits for personal injuries, including death, and damages to property caused by my act or omission
arising out of my participation in the Team Suzuki Support Rider contingency program for 2003, and from all
judgements recovered and from all expenses incurred in defending said claims or suits.
I further agree that without compensation, my name, as well as any photographs, pictures, slides or movies taken of
myself or made in connection with my participation in the Team Suzuki Support Rider contingency program for 2003,
or any reproduction from the same, may in any manner be used by SAPL, or by any person, corporation or
association authorised by SAPL.
I am in good health and have no physical conditions that would prevent me from participating in
motorcycle racing.
I understand that only RM250, RM125, DR-Z400, DR-Z400E, DR-Z250, GSX-R1000, GSX-R750 and
GSX-R600 models are eligible for the Team Suzuki Support Rider contingency program. I agree to complete this
contingency application and submit it to SAPL within 30 days of receipt, to qualify for payment.
I understand that it
is my responsibility to resolve race result disputes with the race organisation. SAPL will only make
payments based on results issued by the race organisation.
