UNDERSTANDING THE RISKS

Rider Name *

First Name

Last Name

Phone *

(###)

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Date of Birth *

MM

DD

YYYY

Emergency Contact *

First Name

Last Name

Phone *

(###)

###

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Track Day Date *

MM

DD

YYYY

Please read carefully: *

I am aware that participating in the miniGP motorcycle track day offered by PowerCorsa Motorsport Limited can be hazardous if they are not conducted with care, control, and responsibility. I acknowledge that these risks could result in my injury (physical or mental) or even death. Medication / Health conditions I acknowledge that participation in this event requires physical stamina, motor coordination, and mental alertness and I hereby attest that I have no known health-related reasons or problems, including physical or mental limitations, that preclude or restrict my participation and will not use any form of alcohol, prescription or non-prescription drugs that could impair my performance in this event. In addition, I attest that I have the skill and balance necessary to drive a vehicle/ride a motorcycle and I am capable of sustaining moderate physical exertion over a period. I consent to receive any medical treatment that may be deemed necessary by PowerCorsa Motorsport Limited in the event of injury, accident or illness while undertaking the activities. I understand it is my responsibility to disclose any conditions (health or otherwise) that may affect the safety and enjoyment of myself and those around me. Conditions of participating I agree to ride with care and obey the rules set out by PowerCorsa Motorsport Limited and instructions given by the guide (or a representative of PowerCorsa Motorsport Limited), at all times. I accept that if I do not adhere to the instructions and rules, or if I act dangerously, recklessly or in a way that might endanger myself or others, PowerCorsa Motorsport Limited may remove me from the activity. If this occurs, I acknowledge I will not receive a refund. I accept that PowerCorsa Motorsport Limited reserves the right to cancel this activity if it becomes concerned for my safety, or the safety of another person. I agree to wear appropriate clothing and use/wear all safety clothing and equipment (as required by the guide) at all times when participating. Limited liability of PowerCorsa Motorsport Limited I understand that if I act recklessly or intentionally, and don’t follow the rules or instructions set out by PowerCorsa Motorsport Limited, which I have been made aware of, PowerCorsa Motorsport Limited will not be held responsible for any injury, damage, or loss I cause to myself/my property (including motorcycle), or another person/their property, resulting from my action (or lack of action). Liability of track owner I agree that the owner(s) of the track on which the activity is conducted will not be held responsible for any death, injury, misadventure, damage to or loss of property caused in whole or part by these activities. Damage to property or equipment In the event that I severely damage any of the motorcycles or equipment, or other property owned by PowerCorsa Motorsport Limited or the track owner, I agree to pay to PowerCorsa Motorsport Limited (or the track owner) all costs associated with repairing the damage. Drugs/Alcohol I confirm I am not under the influence of intoxicating alcohol or drugs (be they legal or illegal) which may in any way impair my ability to undertake the activity. I agree to adhere to the tracks no smoking policy.

I Agree

Marketing *

I give PowerCorsa Motorsport Limited permission to send me emails and/or post relating to PowerCorsa Motorsport Limited events and promotions, as well as the right to use all photos and videos of me taken during the activity for promotional and social media purposes.

I Agree

I Disagree

PARTICIPANT SIGN-OFF *

I agree that by signing this ‘Understanding the Risks form’: 1. I accept there are inherent risks and hazards associated with participating in the activity and I understand what these risks are (including serious harm and death); 2. I am physically and mentally fit to participate and there is nothing I am aware of that will affect my ability to safely ride a motorcycle, or impact the safety of other riders. 3. I wish to proceed with the activity at my own risk.

I agree

Declaration: *

(parent or guardian if under the age of 16 years)

First Name

Last Name