Jul 14, 2018 - The KTM ORANGE ENDURO 2018 is solely organized by KTM Malaysia (Eurotech Wheel Distribution S/B). 2. ONLY
REGISTRATION FORM Event Venue Date
: KTM ORANGE ENDURO 2018 (ROUND 2) : KTM MX ENDURO TRACK, SUNGAI BUAYA, SELANGOR : 14 JULY 2018
Personal Particulars : Full Name as per NRIC : ……………………………………………………….……………………………. Contact No : ……………………………………….……… Email :…………….…………………………… Date of Birth : …………………………………………..… Nationality : …………………………………… NRIC / Passport No : ………………………………………………………………………………………… Mailing / Residential Address : ..……………………………………………………………………………. ………………………………………………………………………………………………………………….. Contact Person Name (In case of emergency) :………………………………………………………….. Contact No
: ………………………………………….. Relationship: ………………………………….
Participating Category :
KTM
NON-KTM
ED1 Open Category
RM100
RM150
ED2 Veteran Open
RM80
RM120
ED3 KTM Enduro
RM80
-
ED4 CKD
-
RM80
ED5 Cubcross
-
RM80
ED6 DP Rally
RM150
RM200
ED7 Women Enduro
RM40
RM40
Bikes Model : …………………………………………………………………………………………………………..…. *Please select your race categor
y.
Rules & Regulations : 1. The KTM ORANGE ENDURO 2018 is solely organized by KTM Malaysia (Eurotech Wheel Distribution S/B). 2. ONLY completed registration form & full payment (payment amount depends category) made are considered as valid registration. 3. Payments will need to be banked in to MBB Account No: 552022-602382 (Eurotech Wheel Distribution S/B) 4. An incomplete form is considered invalid for registration. 5. Riders are required to prepare their own FULL body racing gear. 6. Riders are required to wear MX / OFFROAD helmet for the race. 7. Each (1) bike is only allowed to be registered under one (1) racer. 8. The Organizer reserves the right to reject any participation at its sole and absolute discretion without having to assign any reasons whatsoever. 9. The decision of KTM Malaysia (Eurotech Wheel Distribution S/B) is final and no correspondence will be entertained.
INDEMNITY DECLARATION AND AGREEMENT I certify that the particulars on this form are true and correct in every particular, to the best of my knowledge. I have read the Rules & Regulations for the KTM ORANGE ENDURO 2018 event and agree to be bound by the rules & regulations stated. In consideration of the acceptance of the entry and being permitted to take part in this event I agree to hold harmless and indemnify and keep indemnified KTM Malaysia (Eurotech Wheel Distribution S/B) and their respective officials, promoters, venue owners, sponsors, marshals representatives, and or other representatives at all times from and against any actions, claims, expenses and or demands in respect of but not limited to death, personal injury, loss of or damage to the person or property of myself, or mechanic(s) and all members of my team (as the case may be), however so ever caused whether arising out of or in connection with this entry or taking part in this event and notwithstanding that the same may be contributed to or occasioned by the actions, inactions and or negligence of the organizers, KTM Malaysia (Eurotech Wheel Distribution S/B) and their respective officials, promoters, venue owners, sponsors, marshals representatives. I agree and understand that KTM Malaysia (Eurotech Wheel Distribution S/B) - the organizer are not liable for providing any forms of additional insurance coverage(s) and that I agree to not hold KTM Malaysia (Eurotech Wheel Distribution S/B) liable for any potential claims. I declare that I do not have any objection to the organizers & their partners and sponsors using photographs & videos (which may contain pictures/footage of me), quotes and testimonials from the event for their promotions & marketing purposes. I declare to the best of my belief that the rider (myself) possess the standard of competence for this event to which this entry elates and having due understanding of the speeds and types of roads/terrain/off road conditions that this event is run on. I understand and declare that it is the condition of my taking part in this competition and agreeing to the form that waives all rights of legal action against fellow competitors and other third parties (whether or not connected to the Organizer and/or the sponsors or associate partners) unless written permission to bring such action(s) is granted by the Organizer. I agree that I have entered into this competition entirely at my own risk. I accept that the Organizers/ KTM Malaysia (Eurotech Wheel Distribution S/B) and their respective officials decline all or any kind of liability whatsoever in connection with any accident howsoever caused by the competitors and their vehicles during the entire event.
Violations of the sporting rules, the technical regulations, unsporting behavior, unsporting riding or behavior damaging the reputation of the KTM ORANGE ENDURO 2018 event can, depending on the severity of the violation, result in disqualification, exclusion from the scoring in the respective round, or exclusion from the race by the Organizer. Each rider will be provided with a team T-shirt which has to be worn on the event day. The rider is obliged to keep their T-shirt flawlessly clean and in an undamaged condition at all times.
I hereby understand and agree to the above clauses under Indemnity Declaration Agreement and I am signing it on my own free will.
……………………………………….. Full Name: NRIC/ Passport No: Date:
PARENT/LEGAL GUARDIAN CONSENT Consent Statement for applicants under 18 years old. I, (print full name):………………………………………………………………………………………………………… of (print address):…………………………………………………………………………………………………………. am the parent/guardian of the above-named (“the minor”) who is under 18 years old. I have read this document and understood its contents, including the exclusion of liability and assumption of risk, and have explained the contents to the minor. I hereby give my consent on allowing the minor in attending/ participating in the event at his / her own risk.
……………………………………. Parent / legal Guardian Signature Date:
