Indemnity and Declaration

I/We hereby make an application to participate in the above-mentioned rally and certify that the
particulars of my vehicle as given overleaf are correct, that I/We have read the Supplementary
Regulations issued by Organisers for the said rally and agree to be bound by any of the International
Sporting Code of the FIM, the General Prescriptions for 4W, Sporting Regulations of FMSCI as well as
the undertaking on this entry form.

I have read the regulations issued for this event and agree to be bound by them. In consideration of
the acceptance of the entry of this vehicle I agree to save harmless and keep indemnified the
Government of India ,the relevant State Governments, the FMSCI, FIA, FIM, Organizers, Sponsors and their
officials, agents, representatives, employees and all persons assisting them in this event and all
owners and tenants of private property traversed from and again stall actions, claims, costs, expenses
and demands in respect of death or injury to my self or any other person or persons or loss or
damage to any property including the vehicle concerned in this event or otherwise how so ever and
not with standing that he same may have been contributed to or occasioned by the negligence of
Organizers, and their officials, agents, representatives, employees and all persons assisting them in this
event. The indemnity shall be binding on my heirs, executors, administrator and legal

I/We also undertake to compensate and or settle all third party damages of any kind, caused by me/us,
my representative/s or who so ever connected with me/us during the event.

I declare that the rider possesses the standard of competence necessary for an event of this type to which
this entry relates, also that the vehicle enter suitable and road worthy for the event. I agree and
undertake to abide by the rules and regulations framed for this event including the condition
sprucedentset out there in and all other Rules and Regulations, which may here in after be framed
Finally I/We hereby acknowledge that I / We am / are fully conversant with the risk and dangers of
Motor Sports in general and this rally in particular which I/WE assume hereby.