Post completed form to: Central Australian Drag Racing Association, PO BOX 434, Alice Springs NT 0871 For Information visit our website: www.cadra.com.au or contact us through the website NOMINATION FORM Please tick the current date 17 May : BIKE/HARLEY CHALLENGE, STREETCAR CHALLENGE & BURNOUT COMP CADRA Championship Racing - Round 2 21 June : ALICE SPRINGS TITLES CADRA Championship Racing - Round 3 17 October : BURNOUT COMP CADRA Championship Racing - Round 4 BRACKET SYMBOL NOTE: ANDRA or CADRA RACER No. (Assigned by (Assigned by CADRA Officials) Bracket Symbol and Race Number are assigned by CADRA Officials and must be displayed on vehicle at all times. CADRA Officials) DRIVER/ RIDER NAME _______________________________________________________________________________________ ADDRESS _______________________________________________________________ POSTCODE ________________ PHONE _________________________ MOB _______________________ EMAIL ________________________________ DRIVERS LICENCE NO. _______________________________ STATE _______________ EXP ____________________ VEHICLE DETAILS _________________________________________________________________________________ YEAR MAKE MODEL BODY STYLE ENGINE DETAILS ___________________________________________________________________________________ YEAR MAKE TYPE ( I-4, I-6, V8, ROTARY ETC. ) DISPLACEMENT CC or CID SPONSORS AND ANNOUNCER INFO: _________________________________________________________________ ____________________________________________________________________________________________________ ____________________________________________________________________________________________________ ____________________________________________________________________________________________________ ____________________________________________________________________________________________________ Please tick all that apply to you I AM ENTERING: DRAG RACING BURNOUT COMP FEES: Street Car/Junior Dragster/Street Bike $50 Super Street/Modified Bike $80 Super Sedan/Modified/Supercharged Outlaw $120 EACH PIT CREW $5 (Max. Pit Crew : 4 S/C Outlaw; 3 Modified Eliminator/Super Sedan; ONE ONLY All other classes) Fees include □ DDL (ANDRA DIVISIONAL DAY LICENCE) - see notes Below NOTES: 1. DDL is required if no ANDRA license 2. DDL Fee is included in Racer Entry Fee SCRUTINEER: Use the attached ANDRA Extended Scrutineering Program Form 28/1 Burnout/Race Fees : $................. Pit Crew Fee/s : $................. TOTAL FEES PAID $................ DECLARATION OF ENTRANTS, DRIVERS & RIDERS EXCLUSION OF LIABILITY, RELEASE AND ACKNOWLEDGEMENT OF RISK In exchange for and as a condition of being allowed to enter, participate, or attend this event I/We agree:  To release ASID, CADRA, ANDRA, promoters, sponsor organizations, land owners and lessees, organizers of this event race teams, competitors, their respective servants, officials, representatives and agents (collectively the "Associated Entities") from all liability for death, personal injury (including burns), psychological trauma, loss or damage (including property damage) ("Harm") howsoever arising from participation in or attendance at the event (including any negligence on the part of the Associated Entities), except to the extent where prohibited by law; That 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;  To attend or participate in the event at my/our own risk. I/We acknowledge that: The risks associated with attending or participating in this event include the risk that I/We may suffer harm as a result of:  Motor vehicles (or parts of them) colliding with other motor vehicles, persons or property;  Acts of violence and other harmful acts (whether intentional or inadvertent) committed by persons attending or participating in the event;  The failure or unsuitability of facilities (including grand‑stands, fences and guard rails and barriers) 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/us. I/We accept the conditions of, and acknowledge the risks arising from, attending or participating in the event and being provided with the event services by the Associated Entities, agree to abide by all their rules and regulations, agree to read and sign all required entry forms, including the Acknowledgement of Risk statement and other such releases as shall be required by CADRA and ANDRA and their insurers. I/We agree to be bound by all rules and regulations of ANDRA and CADRA; to include supplementary regulations per the ASID Racer's Information Sheet, and as verbally given at anytime by ANDRA, CADRA, and ASID officials. I/We the lawful vehicle owners(s) (Entrants) and/or driver/rider certify that the particulars on this entry form are true and correct in every detail to the best of my/our knowledge. I/We the lawful owners (Entrants) of the vehicle nominated on this form do hereby apply to enter the vehicle into competition for this event. Driver / Rider Signature ___________________________________________________ DATED ____________________ Pit Crew Signature _______________________________________________________ DATED ____________________ Owners Signature(s) _______________________________________________________ DATED ____________________  If Driver/Rider is under age of 18 years, the following Parent/Guardian Consent must be completed: I (Printed Name) ______________________________________________________________________________________ of (Address) __________________________________________________________________________________________ am the parent/guardian of the above named (the minor) who is under 18 years old. I have read and understand the contents of this document, including the exclusion of liability and assumption of risk, and have explained the contents to the named minor. I consent to the minor attending / participating in the event at his or her own risk. Parent / Guardian Signature _____________________________________________________ DATED _________________ HELMET, LONG SLEEVED SHIRT, LONG TROUSERS & COVERED SHOES REQUIRED FOR ALL COMPETITORS SUPPORT DRAG RACING: PLEASE - NO BYO ALCOHOL & NO GLASS CONTAINERS ! BURNOUT COMPETITION