Registration Form

Please type or write clearly in BLOCK LETTERS. Form must be complete in all respect


Note :

Please Upload Photo copy proof for above documents.

Document should be in jpg / jpeg / png format only.

Max size for documents is 1MB.

Driver license compulsory & others optional.

All other Documents should be submitted by 24th Feb 2017 on rallytovalley@gmail.com along with Your registration id if not submitted here.

Indemnity Declaration Letter

We, hereby make an application to participate in the "WIAA Women's Drive, 2017" and certify that the particulars of our vehicle as stated in the application forms are correct and further that we have read the WIAA
Women's Drive Supplementary Rules and Regulations, 2017 issued by the Organizers of the event. We DO AGREE TO BE BOUND by these regulations.

DECLARATION

We have read the WIAA Women's Drive Supplementary Rules and Regulations, 2017 issued for this event and agree to abide by them in consideration of the acceptance of the entry of this vehicle. We agree that we and our co-passengers (if any) will save harmless and keep indemnified the government of India, the state of Maharashtra, the FIA, the FMSCI, the organizers WIAA the promoters, the sponsors and their officials, agents, representatives, employees and all persons assisting in this event and all owners and tenants of private property traversed from and against all actions, claims, costs, expenses, and demands in respect of death, injury to ourselves or our co-passengers, or any other persons or loss or damage to any property including the vehicle concerned in this event or otherwise howsoever and notwithstanding that the same may have been contributed to or occasioned by the negligence of their officials, agents, representatives, employees, and all persons assisting them in this event. The indemnity shall be binding on our and/or our co-passengers' heirs, executors, administrators, and legal representatives. We agree that we and our co-passengers (if any) undertake not to agitate, litigate or seek a decision of a court of law on any matter or question concerning or relating to the rally coming from the submission of the entry form up to the conclusion of the declaration and distribution of prizes. We also renounce and relinquish our rights, if any, to have recourse to any arbitrator, tribunal not provided for in WIAA Women's Drive Supplementary Rules and Regulations.

Finally, we and our co-passengers (if any) hereby acknowledge that we are conversant with the risks and dangers of motor sport in general and this event in particular, for which we hereby assume to be solely responsible.

I agree on behalf of
Driver
Navigator
Co-Passenger 1
Co-Passenger 2