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2012
WALKY 100
These Event Supplementary Regulations are an extension to the 2012 Series Regulations and must be read together
2011 Outright Winners. Russell Marker / Karien Heimsohn. Photo by Phil Williams
23rd June 2012 Robertstown Environs
Walkerville All Cars Club Inc.
Round 3 of the 2012 SA Rally Championship
Event Supplementary Regulations
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Message from the Clerk of Course
2012 marks the 28th running of the COPYWORLD Walky 100. Initially Robertstown was the half way point of the old 500 mile, overnight navigation trials that started in Adelaide or Morgan. This began the Walky 500 tradition. In 1984 Ted Dobrzynski found a few roads that were used in the trials events and closed them to the general public and unleashed the first instalment of the special stage format.
The Southern Saints Football Club oval has become the traditional headquarters and service/camping area for the event. Geoff Hobby, Andrew Challen, Scott Hochwald, Steve Rowe, Kathy Allen and myself, have all followed Ted. We have enjoyed great support from the locals.
The Robertstown event has a tradition of using some tried and true roads every year, and this year is no different. Some roads that have been favourites for the past 27 years are back again, along with others which were only introduced in the last few years. We have approximately 115 kms of competition roads planned for this year’s edition of the event. This year, the event starts at 11:00 am and the first car is due home about 7:30 pm. This leaves us with the most traditional element of the Robertstown event. The mixture of daylight and night stages makes for one of the highlights of many competition crews, both local and interstate.
The 2012 COPYWORLD Walky 100 shall open with the stage called One Big Hill (formerly known as The Plains). This stage is well known for the famous triple jump near the end of the stage, which is also the first spectator point of the event only 15kms from Robertstown Oval. Stage 2 is Eagle Hawk, with a 4km modified start to the stage commonly known as Dips but heading in the same direction as last year. Hallelujah Range is stage 3. It is one of the most well known of stages with the more seasoned competitors, the rolling crests make for some very enjoyable experiences. After a fast straight, you will head into Scrubby Range, back to a stage that was used in the mid 1980’s. You will complete these 3 stages twice. We then head south west up over the range from Point Pass for Julia Who (stages 7 and 10) and the new stage Wayne Who (stages 8 and 11). Both stages comprise flowing council roads with spectator points available at road junctions.
Then we return to an old favourite with recent flavourings, Inspiration Point. When you add the council road in between, you come up with a very tasty 12km stage called Roast. This can be a lot of fun in the wet as there are several sections along the top of the ridge that contain a good mix of clay, and then finish with a fast flowing finish. From a spectating viewpoint there are four road junctions that are easily accessible and will show the commitment and skill of the crews to good effect.
So, Saturday June 23rd all roads lead to Robertstown for Round 3 of the 2012 SARC. Thanks to the many organisations, including the Regional Council of Goyder, SA Police, ACRM, St Johns, Southern Saints Football Club and the without this support we would be unable to run the event. A special mention must also be made of the landowners adjacent the road sections over which the event runs. And the sponsors and supporters that are currently on-board, Copyworld, Rudham Lawyers, Parsons Tabo, Saratoga Distribution, Les Haldane Mechanical, Autosport, Warner Fork Trucks and Subareck.
On behalf of the organising committee, I welcome you to Robertstown and the 2012 COPYWORLD Walky 100.
We look forward to your support of this event and seeing you in Robertstown!
Scott Atkinson
CLERK OF COURSE
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List of Contents
List of Contents ............................................................................................................................................ 3
I. EVENT PROGRAM ................................................................................................................................... 4
II. GENERAL INFORMATION ....................................................................................................................... 5
III. ORGANISATION ..................................................................................................................................... 6
Article 1. - ORGANISATION ...................................................................................................................... 6
Article 3. - EVENT DETAILS ..................................................................................................................... 7
Article 6. - ENTRIES AND ENTRY FEE .................................................................................................... 7
Article 7. - SERVICING AND REFUELLING .............................................................................................. 8
Article 8. – RECONNAISSANCE AND PACE NOTING ............................................................................. 8
IV. DOCUMENTATION & SCRUTINY .......................................................................................................... 8
Article 10. - DOCUMENTATION AND SCRUTINY .................................................................................... 8
V. RUNNING OF THE RALLY ...................................................................................................................... 8
Article 11. - START ................................................................................................................................... 8
VI. AWARDS ................................................................................................................................................ 9
Article 16 – PRIZES, TROPHIES AND AWARDS ..................................................................................... 9
Article 18. - RESULTS .............................................................................................................................. 9
VIII. ITINERARY ......................................................................................................................................... 10
ENTRY FORM ............................................................................................................................................... i
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I. EVENT PROGRAM
Monday
14th May 2012
0900 hrs Entries open Rally Office
Thursday
7th June 2012
2000 hrs Final Entries close Rally Office
Tuesday 12th June 2012 1900 hrs
Seeded list of entries published Official Website
Saturday 16th June 2012 1400 – 1600 hrs
Road book collection for Sunday Reconnaissance
Rally Office (City Location)
Sunday 17th June 2012 0800 – 1600 hrs
Reconnaissance Day 1 Robertstown
Thursday
21st June 2012 1900-2030 hrs
1900-2200 hrs
1900-2200 hrs
Documentation verification (Includes distribution of Road Books, Service Guide, Door Numbers and Sponsor Advertising)
Turbo Charger Scrutiny & Sealing
Scrutineering
Scrutineering
Friday
22nd June 2012 0800-0830 hrs
0800 – 1600 hrs
Rally Headquarters Opens Distribution of Road Books, Service Guide, Door Numbers and Sponsor Advertising, for country competitors)
Reconnaissance Day 2
Rally Headquarters
Robertstown
Saturday
23rd June 2012 0700 hrs
0800 - 0930 hrs
1000 hrs
1030 hrs
1100 hrs
1929 hrs
2156 hrs
2000 - 2200hrs
2200 hrs
2300 hrs
Rally Headquarters opens
Re-scrutineering
Competitors’ Briefing
Cars to Staging Area
First Car Starts
First Car Due to Finish
Last Car Due to Finish (50 cars)
Post Event Scrutineering
Provisional Results posted and Trophy Presentation
Rally Headquarters Closes
Rally Headquarters
Wednesday 18th July 2012 2000-2030 hrs
Awards Presentation
Walkerville RSL Hall
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II. GENERAL INFORMATION
RALLY ENQUIRIES Email: [email protected]
Scott Atkinson
Mbl: 0407 606 766 Email: [email protected]
Jeremy Browne
Mbl: 0418 814 494 Email: [email protected]
MEDIA ENQUIRIES Phil Williams Mbl: 0407 603 978 Simon West Mbl: 0412 913 120
Email: [email protected]
CORRESPONDENCE: Address all correspondence to: The Event Secretary 2012 COPYWORLD Walky 100 PO Box 346 Nairne 5252
Email: [email protected]
No responsibility will be accepted by the organisers for any correspondence sent to any other address
OFFICIALS Greta Nason
Mbl: 0419 031 058 Email: [email protected]
RALLY OFFICE: 2012 COPYWORLD Walky 100
Main Office: 37 Addison Rd, Hove, SA, 5048
City Office for Road Book collection only:
37 Addison Rd, Hove
RALLY HEADQUARTERS: Southern Saints Football Club
Robertstown Oval
South Australia
OFFICIAL NOTICE BOARD: Up to and including Friday 22nd June 2012; And after the closure of Rally Headquarters. http://www.wacc.asn.au/Events/2012copyworldwalky100/
Then from 0700 hrs Saturday 23rd June 2012 the Notice Board will be in operation at Rally Headquarters during the conduct of the Rally.
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III. ORGANISATION
Article 1. - ORGANISATION
1.1 ORGANISATION AND PROMOTION
The organiser and promoter of the 2012 COPYWORLD Walky 100 is the Walkerville All Cars Club Inc. Whilst the core organising team has been selected from the WACC, all of the following clubs are represented in various positions: Walkerville All Cars Club Inc Southern Districts Car Club Inc Rallysport Car Club of South Australia Inc ACRM The 2012 COPYWORLD Walky 100 will be a State Championship Special Stage Rally, run under the provisions of the International Sporting Code of the FIA, the National Competition Rules (NCR) of CAMS, the National Rally Code, 2012 SA Conditions of Rallying, 2012 SARC Series Supplementary Regulations, these Event Supplementary Regulations and any authorised further regulations and Bulletins.
1.2 OFFICIALS OF THE RALLY
CAMS Stewards of the Meeting Robert Whyatt Adrian Flynn Mark Warner Course Checker Jason Lange
1.3 ORGANISING COMMITTEE
Clerk of Course Scott Atkinson Mobile: 0407 606 766 Email: [email protected] Licence: No. 88442 Deputy Clerk of Course Jeremy Browne Mobile: 0418 814 494 Email: [email protected] Licence: No. 888910 Secretary Kimberley Franklin Mobile: 0402 211 085 Email: [email protected]
Licence: No. 1070032
Officials Coordinator Greta Nason Mobile: 0419 031 058 Email: [email protected] Licence: No. 9700999 Media / Public Relations Phil Williams Mobile 0407 603 978 Email: [email protected] Results Manager Jim Penhale Email: [email protected]
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Chief Scrutineer Bob Nason Mobile: 0409 676 649 Email: [email protected] Competitor Relations Officer Lynette Marker Compliance Checker Matt Monto
Article 3. - EVENT DETAILS
3.3 The CAMS Permit Number authorising the event is 512/2306/01
3.4 The length of the rally will be approximately 295 kms, including 12 stages which have a total competitive distance of approximately 116 kms. All special stages are of a gravel/dirt surface, held in the Regional Council of Goyder, on (closed) public & private roads.
3.5 The Event will consist of one Heat on one day.
Article 6. - ENTRIES AND ENTRY FEE
6.1 Completed entries together with the appropriate fee as prescribed in Article 6.4 of these regulations should be sent to:
The Event Secretary 2012 COPYWORLD Walky 100 PO Box 346 Nairne SA 5252
6.2 Entries open 0900 hrs on Monday 14th May 2012
6.3 Final Entries close 2000 hrs on Thursday 7th June 2012
6.4 The entry fee for the Event is fixed as follows:
Registered SARC $ 545.00 Non Registered SARC $ 595.00 The entry fee includes – CAMS Permit Fee CAMS SARC Trophy Fund CAMS Road Repair Fund One set of Road Books One Service crew registration One set of Service Crew Instructions One set of Spectator Instructions Medical Intervention Teams Payment may be made in:
� In Cash to the Event Secretary in person OR � By Cheque / Money Order payable to “Walkerville All Cars Club Inc” OR � By Electronic Funds Transfer (EFT) to:
BSB 105-137 Account No 521056840 Account Name Walkerville All Cars Club Description / Reference <Competitor Name> IMPORTANT NOTE: The EFT Description / Lodgement Reference MUST be specified as the name of the competitor (ie. NOT Robertstown Rally or Walkerville All Cars Club). A written or printed receipt MUST be provided with the entry form for ease of processing.
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Article 7. - SERVICING AND REFUELLING
7.1 The maximum distance between nominated Service Parks and refuel zones will be approximately 70.00km (including 31.00km competitive).
7.2 Fuel will be available at the following locations:-
a - SAFF Eudunda has unleaded, Premium unleaded, Diesel and LPG. b - Robertstown Mobil has unleaded, Premium unleaded & Diesel (only open until 1200 hrs).
Article 8. – RECONNAISSANCE AND PACE NOTING
8.10 Reconnaissance will be available on either:
Recce Day 1; Sunday 17th June 2012 between 0800 hrs – 1600 hrs. Recce Day 2; Friday 22nd June 2012 between 0800 hrs – 1600 hrs.
Article 9 – ODOMETER CHECK As detailed in the 2012 SA Conditions of Rallying.
There will also be a 5km check on the road approaching Robertstown and detailed in the Rally Route Instructions.
IV. DOCUMENTATION & SCRUTINY
Article 10. - DOCUMENTATION AND SCRUTINY
10.1 Documentation will be available during the following times and must be completed prior to presentation of that vehicle for scrutiny:
Thursday 21st June 2012, 1900 hrs till 2030 hrs at Tyrepower St Agnes, 121 Tolley Road, St Agnes, 5097 SA, Phone: (08) 8264 1777 OR, where approved, Saturday 23rd June 2012, 0700 hrs till 0900 hrs at Rally Headquarters, Robertstown Oval.
10.2 Vehicles must be presented for scrutiny on Thursday 21st June 2012 between 1900 hrs and 2200 hrs (unless granted an exemption by the Chief Scrutineer) at: Tyrepower St Agnes, 121 Tolley Road, St Agnes, 5097 SA. Failure to comply with these requirements will result in a time penalty being imposed at the discretion of the Stewards of the Meeting.
Regional and interstate competitors must apply to the Chief Scrutineer, in writing, to have scrutiny undertaken by the appropriate scrutineering authority in their local area. These competitors must present their documentation along with the endorsed scrutiny ‘pass’ form at the Scrutineering Marquee on Saturday 23rd June 2012, 0800 hrs till 0900 hrs. It’s the crew’s responsibility to present their apparel for checking on the day, before 0900 hrs.
10.3 Vehicles requiring re-scrutiny, or those vehicles granted an exemption from Article 10.2 are required to attend scrutiny at Scrutineering Marquee, Robertstown Oval on Saturday 23rd June 2012, 0800 hrs till 0930 hrs.
10.4 Turbo Scrutiny will be held for all vehicles fitted with a turbocharger on Thursday 21st June 2012 during normal process at the scrutiny venue, listed in 10.2. Vehicles granted exemption from Article 10.2 will be scrutineered as per Article 10.3
V. RUNNING OF THE RALLY
Article 11. - START
11.1 Both driver and co-driver MUST be present at the Competitors’ briefing at 1000 hrs on Saturday 23rd June 2012 at Rally Headquarters. Non attendance will be reported to the Stewards and the recommended penalty will be exclusion.
11.2 The Rally will start at 1100 hrs on Saturday 23rd June 2012 and the first car will finish at approx
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1930 hrs at Southern Saints Football Club, Robertstown.
11.3 Competing Vehicles are required to be placed in the Staging area (refer to the road book) no later than 1030 hrs.
It is not necessary that a member of the crew is the person who places the vehicle in the staging area. In accordance with the above regulations, a map of the location and directions will be provided to competitors in the road books.
11.4 Late arrival – See Series Regulations
11.5 Cars will start special stages at 2 minute intervals until SS6. From the second regroup, the interval may be adjusted to suit the weather conditions at the time.
11.6 Special Stages will be closed to competition when the slow sweep enters the stage. Any crew who arrives at a special stage time control within their late time limit but after the stage has closed to competition, are to drive the stage abiding by all applicable road regulations. A derived time considered by the stewards to be fairest will be given to the crew. Crews are to enter their own start and finish times on the time card if the control officials have packed up and/or have left the control area. Any crew that stops on a stage and is passed by the sweep is deemed to have withdrawn from that stage.
VI. AWARDS
Article 16 – PRIZES, TROPHIES AND AWARDS
16.1 The Trophy Presentations based on provisional results will be held at Saturday 23rd June 2012, 2200 hrs at Rally Headquarters, Robertstown Oval (will be earlier if possible).
16.2 The Revolution Racegear Award will be advised via a bulletin.
16.3 Walkerville All Cars Club Inc Member Awards: The “Walky 500 Trophy” shall be presented to the highest placed crew who are both financial members of the Walkerville All Cars Club Inc at the close of entries. The award will be presented at the A.G.M. in December.
Article 18. - RESULTS
See Series Regulations. Provisional and final results will be posted on the official 2012 COPYWORLD Walky 100 Website: http://www.wacc.asn.au/Events/2012copyworldwalky100/
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VIII. ITINERARY
Road Section
Location Road
Section Distance
Stage Distance
Time Allowed
Road Closed
1st Competitor
Last Competitor
Road Open
TC 1.0
5.15 12 11:00 12:18
TC 1.1 11:12 12:30
SS1 One Big Hill 1 7.67 10:15 11:15 12:33 16:00
TC 1.1
29.29 32 11:15 12:33
TC 1.2 11:47 13:05
SS2 Eagle Hawk 1 9.07 10:45 11:50 13:08 16:30
TC 1.2
16.73 19 11:50 13:08
TC 1.3 12:09 13:27
SS3 Hallelujah Range 1 14.13 10:50 12:12 13:30 16:45
TC 1.3
16.94 19 12:12 13:30
TC 1.3A 12:31 13:49
Competitive 30.87 Liaison 37.24 Total 68.11
REGROUP A 15 Minutes
SERVICE A 20 Minutes
Road Section
Location Road Section Distance
Stage Distance
Time Allowed
Road Closed
1st Competitor
Last Competitor
Road Open
TC 1.3C
5.21 15 13:06 14:24
TC 1.4 13:21 14:39
SS4 One Big Hill 2 7.67 10:15 13:24 14:42 16:00
TC 1.4
29.29 32 13:24 14:42
TC 1.5 13:56 15:14
SS5 Eagle Hawk 2 9.07 10:45 13:59 15:17 16:30
TC 1.5
16.73 19 13:59 15:17
TC 1.6 14:18 15:36
SS6 Hallelujah Range 2 14.13 10:50 14:21 15:39 16:45
TC 1.6
16.94 19 14:21 15:39
TC 1.6A 14:40 15:58
Competitive 30.87 Liaison 37.30 Total 68.17
REGROUP B 0:20 HH:MM * FIELD CHANGES TO 3 MIN GAP
SERVICE B 0:30 HH:MM
The information on this page is based on 40 Cars at 2 minute intervals. Please check the website and the roadbook for updates: http://www.wacc.asn.au/Events/2012copyworldwalky100/
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Road Section
Location Road
Section Distance
Stage Distance
Time Allowed
Road Closed
1st Competitor
Last Competitor
Road Open
TC 1.6C TC 1.7
17.28 20 15:30 15:50
17:15 17:35
SS7 Julia Who? 1 7.63 15:00 15:53 17:38 21:00
TC 1.7
22.40 25 15:53 17:38
TC 1.8 16:18 18:03
SS8 Wayne Who? 1 5.90 15:30 16:21 18:06 21:30
TC 1.8 TC 1.9
15.97 20
16:21 16:41
18:06 18:26
SS9 Roast 1 12.77 16:00 16:44 18:29 22:00
TC 1.9
23.50 26 16:44 18:29
TC 1.9A 17:10 18:55
Competitive 26.30 Liaison 52.85 Total 79.15
REGROUP C 0:15 HH:MM
SERVICE C 0:20 HH:MM
Road Section
Location Road
Section Distance
Stage Distance
Time Allowed
Road Closed
1st Competitor
Last Competitor
Road Open
TC 1.9C
17.28 20 17:45 19:30
TC 1.10 18:05 19:50
SS10 Julia Who? 2 7.63 15:00 18:08 19:53 21:00
TC 1.10
22.40 25 18:08 19:53
TC 1.11 18:33 20:18
SS11 Wayne Who? 2 5.90 15:30 18:36 20:21 21:30
TC 1.11 TC 1.12
15.97 20
18:36 18:56
20:21 20:41
SS12 Roast 2 12.77 16:00 18:59 20:44 22:00
TC 1.12
23.50 26 18:59 20:44
TC 1.12A 19:25 21:10
Finish & Parc Ferme 19:25 21:10
Competitive 26.30 Liaison 52.85 Total 79.15
Event Totals
Competitive 114.34 Liaison 180.24 Total 294.58
The information on this page is based on 35 Cars at 3 minute intervals. Please check the website and the roadbook for updates: http://www.wacc.asn.au/Events/2012copyworldwalky100/
Version – February 2007
Entry Form Page i of viii
ENTRY FORM
2012 COPYWORLD Walky 100 Saturday 23rd June 2012
Held under the International Sporting Code of the FIA and the National Competition Rules of CAMS Permit 512/2306/01
Please place a tick for each Event you are entering
SA Rally Champ.
Recce Day: Sunday 17th June or Friday 22nd June
COMPETITOR (CAR OWNER)
Name:
Address: Postcode:
Telephone: Mobile (hm) (wk)
CAMS Licence: Number: Expiry Date:
DRIVER
Name: Date of Birth:
Address: Postcode:
Telephone: (mobile) (hm) (wk)
Email:
Civil Licence Number: Club: Club Member No:
CAMS Licence Number: Type: CR NR NRJ Expiry Date:
Emergency contact Person: Name: Mobile:
Emergency contact Person: Name: Mobile:
CO- DRIVER / NAVIGATOR
Name: Date of Birth:
Address: Postcode:
Telephone: (mobile) (hm) (wk)
Email:
Civil Licence Number: Club: Club Member No:
CAMS Licence: Number: Type: CR NR NRJ Expiry Date:
Emergency contact Person: Name: Mobile:
Emergency contact Person: Name: Mobile:
Version – February 2007
Entry Form Page ii of viii
PACENOTING VEHICLE REGISTRATION DESCRIPTION OF CAR
Make: Model: Year:
Colour: Registration Number: Reg. Expires:
SERVICE CREW REGISTRATION DESCRIPTION OF CAR 1
Make: Model: Year:
Colour: Registration Number: Reg. Expires:
SERVICE CREW REGISTRATION DESCRIPTION OF CAR 2
Make: Model: Year:
Colour: Registration Number: Reg. Expires:
Signature Date
Competitor
Driver
Co-Driver/Navigator
Enclosed is CASH / CHEQUE / MONEY ORDER / EFT Receipt for the sum of $I.IIIIII..I. being entry fee for the event.
VEHICLE DESCRIPTION
Make: Model: Year:
Body Type: Registration Number: Reg. Expires:
Colour: Logbook No:
Class:
OFFICIAL USE ONLY SARC
Date ReceivedQQQQ..QQQ.Time ReceivedQQQQQQQ...Entry form fully Completed (Yes / No). Amount Paid $QQQ.QQQQQ Payment Details cheque / money order / cash / EFT
CAMS Licence
CAMS Passbook
Club Membership
Disclaimer
U18 Disclaimer
Navigator Only Disc.
Service Crew Car 1
Service Crew Car 2
Extra Road Book
Version – February 2007
Entry Form Page iii of viii
DISCLAIMER EXCLUSION OF LIABILITY, RELEASE AND ASSUMPTION OF RISK
COMPETITORS AND/OR COMPETING CREWS AND/OR SERVICE CREW IN RALLIES For Competitors I/We being the competitor/s of the vehicle described on this Entry Form wish to enter that vehicle for the above event.
For Competitors and competing crew/ and service crew I/We being the competitor/s and/or driver and/or co-driver and/or navigator and/or service crew, certify that the particulars on this form are true and correct in every particular, to the best of my/our knowledge and belief.
I/We declare that I/we have read and understood the Supplementary Regulations issued for the event, and agree to be bound by them and the provisions of the National Competition Rules of the Confederation of Australian Motor Sport Limited (“CAMS”).
In exchange for being able to attend or participate in the event (including entering the event), I agree: • to release CAMS and Australian Motor Sport Commission Ltd, promoters, sponsor organisations, land
owners and lessees, organisers of the event, their respective servants, officials, representatives and agents (collectively, the "Associated Entities") from all liability for my death, personal injury (including burns), psychological trauma, loss or damage (including property damage) ("harm") howsoever arising from my participation in or attendance at the event, except to the extent prohibited by law;
• that CAMS and the Associated Entities do not make any warranty, implied or express, that the event services will be provided with due care and skill or that any materials provided in connection with the services will be fit for the purpose for which they are supplied; and
• to attend or participate in the event at my own risk.
I/we acknowledge that: • the risks associated with attending or participating in the event include the risk that I may suffer harm as a
result of: o motor vehicles (or parts of them) colliding with other motor vehicles, persons or property; o acts of violence and other harmful acts (whether intentional or inadvertent) committed by persons
attending or participating in the event; and
o the failure or unsuitability of facilities (including grand-stands, fences and guard rails) to ensure the safety of persons or property at the event.
• motor sport is dangerous and that accidents causing harm can and do happen and may happen to me. • the route instructions should not be relied upon exclusively in estimating the degree of severity of any hazard
which might be encountered, or the manner in which any section of the road is driven, whether shown in the route instructions or not, and that I/We have been advised to exercise caution in following these route instructions.
I accept the conditions of, and acknowledge the risks arising from, attending or participating in the event and being provided with the event services by CAMS and the Associated Entities.
I/we acknowledge that my/our personal information will be processed in accordance with the CAMS privacy policy which is available from the www.cams.com.au and where I/we suffer from any injury, sickness or death during the Event, I/we consent to the release by health services of my/our personal health information to an authorised representative of CAMS or the Event who may use it in the preparation and release within and outside Australia of accident or incident information and reports to interested parties for the purposes of accident investigation, accident prevention and safety activities, news services including broadcast services, or for the purposes of processing insurance claims.
I understand that this disclaimer is not intended to exclude any valid claim I may have under the CAMS Personal Insurance Scheme.
Competitor's signature: .................................................. .Date: ........................................
Driver/s signature: ......................................................... Date: ........................................
Navigator/Co-Driver/s signature: ........................................ Date: ........................................ For persons under the age of 18 years the following parent/guardian consent must be completed.
PARENT/ GUARDIAN CONSENT – PERSONS UNDER 18 YEARS OLD I QQQQQQQQQQQQQQ of [Address] QQQQQQQQQQQQQQQQQQQ am the parent/ guardian* of the above-named ("the minor") who is under 18 years old. I have read this document and understand its contents, including the exclusion of liability and assumption of risk, and have explained the contents to the minor. I consent to the minor attending/ participating in* the event at his/her own risk. SignedQQQQQQQQQQQQQQQ DateQQQQQQQQQQQQQQQ
Parent/Guardian* Delete whichever does not apply
Entry Form Page v of vii
DISCLAIMER EXCLUSION OF LIABILITY, RELEASE AND ASSUMPTION OF RISK
RALLY SERVICE CREW DISCLAIMER
For Service Crew
I/We being a member of/the service crew certify that the particulars on this form are true and correct in every particular, to the best of my/our knowledge and belief.
In exchange for being able to attend or participate in the event, I/we agree: • To release Confederation of Australian Motor Sport Ltd ("CAMS") and Australian Motor Sport Commission Ltd,
promoters, sponsor organisations, land owners and lessees, organisers of the event, their respective servants, officials, representatives and agents (collectively, the “Associated Entities”) from all liability for my death, personal injury (including burns), psychological trauma, loss or damage (including property damage) (“harm”) howsoever arising from my participation in or attendance at the event, except to the extent prohibited by law:
• That CAMS and the Associated Entities do not make any warranty, implied or express, that the event services will be provided with due care and skill or that any materials provided in connection with the services will be fit for the purpose for which they are supplied: and
• To attend or participate in the event at my own risk. • That Service crew members must be over the age of 16 years. Where a person under 18 years is part of a
service crew they require parental/ guardian consent and that crew member/s must be under adult supervision at all times.
I/We acknowledge that: • The risks associated with attending of participating in the event include the risk that I may suffer harm as a
result of: o Motor vehicles (or parts of them) colliding with other motor vehicles, persons or property: o Acts of violence and other harmful acts (whether intentional or inadvertent) committed by persons attending
or participating in the event; and o The failure or unsuitability of facilities (including grand-stands, fences and guard rails) to ensure the safety
of persons or property at the event. • Motor sport is dangerous and that accidents causing harm can and do happen and may happen to me. • The route/service crew instructions should not be relied upon exclusively in estimating the degree of severity of
any hazard which might be encountered, or the manner in which any section of the road is driven, whether shown in the route instructions or not, and that I/we have been advised to exercise caution in following these route/service crew instructions.
I accept the conditions of, and acknowledge the risks arising from, attending or participating in the event and being provided with the event services by CAMS and the Associated Entities.
I/we acknowledge that my/our personal information will be processed in accordance with the CAMS privacy policy which is available from the www.cams.com.au and where I/we suffer from any injury, sickness or death during the Event, I/we consent to the release by health services of my/our personal health information to an authorised representative of CAMS or the Event who may use it in the preparation and release within and outside Australia of accident or incident information and reports to interested parties for the purposes of accident investigation, accident prevention and safety activities, news services including broadcast services, or for the purposes of processing insurance claims.
Entry Form Page vi of vii
I understand that this disclaimer is not intended to exclude any valid claim I may have under the CAMS Personal Insurance Scheme.
NameQQQQQQQQQQQQQQQQQQQ (print) SignedQQQQQQQQQQQQQQQQQQQ
DateQQQQQQQQQQQQQQQQQQQ
NameQQQQQQQQQQQQQQQQQQQ (print) SignedQQQQQQQQQQQQQQQQQQQ
DateQQQQQQQQQQQQQQQQQQQ
NameQQQQQQQQQQQQQQQQQQQ (print) SignedQQQQQQQQQQQQQQQQQQQ
DateQQQQQQQQQQQQQQQQQQQ
NameQQQQQQQQQQQQQQQQQQQ (print) SignedQQQQQQQQQQQQQQQQQQQ
DateQQQQQQQQQQQQQQQQQQQ
NameQQQQQQQQQQQQQQQQQQQ (print) SignedQQQQQQQQQQQQQQQQQQQ
DateQQQQQQQQQQQQQQQQQQQ
NameQQQQQQQQQQQQQQQQQQQ (print) SignedQQQQQQQQQQQQQQQQQQQ
DateQQQQQQQQQQQQQQQQQQQ
For persons under the age of 18 years the following parent/guardian consent must be completed. Note: 16 years is the minimum age for a member of the service crew.
PARENT/ GUARDIAN CONSENT – PERSONS UNDER 18 YEARS OLD
I QQQQQQQQQQQQQQ of [Address] QQQQQQQQQQQQQQQQQQQ am the parent/ guardian* of the above-named ("the minor") who is under 18 years old. I have read this document and understand its contents, including the exclusion of liability and assumption of risk, and have explained the contents to the minor. I consent to the minor attending/ participating in* the event at his/her own risk.
SignedQQQQQQQQQQQQQQQQQQQQQQ.
Parent/Guardian*
DateQQQQQQQQQQQQQQ
* Delete whichever does not apply
Entry Form Page vii of vii
2012 COPYWORLD WALKY 100
MEDIA INFORMATION
DRIVER CO-DRIVER
Name Name
Nick Name Nick Name
Age Age
Occupation Occupation
Home Town State Home Town State
Car Club(s) Car Club(s)
Best Two Rally Results
Most Spectacular Retirement
Additional Info
VEHICLE
Make Year Model
Class Drive RWD / FWD / 4WD Colour
Capacity cc
Modifications
History of Car
Other Info
Sponsors
Form SR-01 2004
Entry Form Page viii of vii
Declaration of co-driver without civil licence National Rally Code, Article 2.1 (iii)
To be completed at Pre-Event Documentation I: ________________________________ CAMS Licence Number_________________ Of: ___________________________________________________________________ In the state of: __________________________ declare and agree that in accordance with the CAMS’ National Rally Code, Article 2.1(iii), I will not drive the car for which I am entered in the Event, being the: _____________________________________________ as I have not presented my civil licence at this time of pre-event documentation. Signature: _____________________________ Date: _______________________ Print Full Name: _____________________________________________________