Off Road Trax Registration Form
(this form to be printed, filled and faxed to 082 363344)

Name (Driver 1): ____________________________________

Driving license No: ___________________________________

Name (Driver 2): ____________________________________

Driving license No: ___________________________________

Address: __________________________________________

_________________________________________________

_________________________________________________

Phone: ___________________________________________

Handphone: _______________________________________

Vehicle type and model: ______________________________

We wish to sign up for:

¨ Session 1: Saturday 15 October, 2005

¨ Session 2: Saturday, 12 November, 2005

Indemnity Release Waiver

I, whose name appears above, hereby declare that I am entering the Off Road Trax - (4x4 Skills Training) at my own accord and thereby do so at my own risk. I acknowledge that this is a training session however subject myself and my vehicle to extreme off road conditions and will NOT hold the organizers and their staff, the event coordinators, land owners, or any persons involved either directly or indirectly with this training responsible for any accidents, vehicle damage, injuries or fatalities that may occur. I will have no claims whatsoever against anyone. I also agree to comply with instructions given by the instructors.

Participation fee RM 60 per vehicle with 2 drivers.

Sign Driver 1 ____________________________________

Sign Driver 2 ____________________________________

Date : __________________________
 

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