These Event Supplementary Regulations are an extension to the 2012 Series Regulations and must be read together

Transcription

1 2012 WALKY 100 These Event Supplementary Regulations are an extension to the 2012 Series Regulations and must be read together 2011 Outright Winners. Russell Marker / Karien Heimsohn. Photo by Phil Williams 23rd June 2012 Robertstown Environs Walkerville All Cars Club Inc. Round 3 of the 2012 SA Rally Championship Event Supplementary Regulations 1

2 Message from the Clerk of Course 2012 marks the 28 th running of the COPYWORLD Walky 100. Initially Robertstown was the half way point of the old 500 mile, overnight navigation trials that started in Adelaide or Morgan. This began the Walky 500 tradition. In 1984 Ted Dobrzynski found a few roads that were used in the trials events and closed them to the general public and unleashed the first instalment of the special stage format. The Southern Saints Football Club oval has become the traditional headquarters and service/camping area for the event. Geoff Hobby, Andrew Challen, Scott Hochwald, Steve Rowe, Kathy Allen and myself, have all followed Ted. We have enjoyed great support from the locals. The Robertstown event has a tradition of using some tried and true roads every year, and this year is no different. Some roads that have been favourites for the past 27 years are back again, along with others which were only introduced in the last few years. We have approximately 115 kms of competition roads planned for this year s edition of the event. This year, the event starts at 11:00 am and the first car is due home about 7:30 pm. This leaves us with the most traditional element of the Robertstown event. The mixture of daylight and night stages makes for one of the highlights of many competition crews, both local and interstate. The 2012 COPYWORLD Walky 100 shall open with the stage called One Big Hill (formerly known as The Plains). This stage is well known for the famous triple jump near the end of the stage, which is also the first spectator point of the event only 15kms from Robertstown Oval. Stage 2 is Eagle Hawk, with a 4km modified start to the stage commonly known as Dips but heading in the same direction as last year. Hallelujah Range is stage 3. It is one of the most well known of stages with the more seasoned competitors, the rolling crests make for some very enjoyable experiences. After a fast straight, you will head into Scrubby Range, back to a stage that was used in the mid 1980 s. You will complete these 3 stages twice. We then head south west up over the range from Point Pass for Julia Who (stages 7 and 10) and the new stage Wayne Who (stages 8 and 11). Both stages comprise flowing council roads with spectator points available at road junctions. Then we return to an old favourite with recent flavourings, Inspiration Point. When you add the council road in between, you come up with a very tasty 12km stage called Roast. This can be a lot of fun in the wet as there are several sections along the top of the ridge that contain a good mix of clay, and then finish with a fast flowing finish. From a spectating viewpoint there are four road junctions that are easily accessible and will show the commitment and skill of the crews to good effect. So, Saturday June 23rd all roads lead to Robertstown for Round 3 of the 2012 SARC. Thanks to the many organisations, including the Regional Council of Goyder, SA Police, ACRM, St Johns, Southern Saints Football Club and the without this support we would be unable to run the event. A special mention must also be made of the landowners adjacent the road sections over which the event runs. And the sponsors and supporters that are currently on-board, Copyworld, Rudham Lawyers, Parsons Tabo, Saratoga Distribution, Les Haldane Mechanical, Autosport, Warner Fork Trucks and Subareck. On behalf of the organising committee, I welcome you to Robertstown and the 2012 COPYWORLD Walky 100. We look forward to your support of this event and seeing you in Robertstown! Scott Atkinson CLERK OF COURSE 2

3 List of Contents List of Contents... 3 I. EVENT PROGRAM... 4 II. GENERAL INFORMATION... 5 III. ORGANISATION... 6 Article 1. - ORGANISATION... 6 Article 3. - EVENT DETAILS... 7 Article 6. - ENTRIES AND ENTRY FEE... 7 Article 7. - SERVICING AND REFUELLING... 8 Article 8. RECONNAISSANCE AND PACE NOTING... 8 IV. DOCUMENTATION & SCRUTINY... 8 Article DOCUMENTATION AND SCRUTINY... 8 V. RUNNING OF THE RALLY... 8 Article START... 8 VI. AWARDS... 9 Article 16 PRIZES, TROPHIES AND AWARDS... 9 Article RESULTS... 9 VIII. ITINERARY ENTRY FORM... i 3

4 I. EVENT PROGRAM Monday 14 th May hrs Entries open Rally Office Thursday 7 th June hrs Final Entries close Rally Office Tuesday 12 th June hrs Seeded list of entries published Official Website Saturday 16 th June hrs book collection for Sunday Reconnaissance Rally Office (City Location) Sunday 17 th June hrs Reconnaissance Day 1 Robertstown Thursday 21 st June hrs hrs hrs Documentation verification (Includes distribution of Books, Service Guide, Door Numbers and Sponsor Advertising) Turbo Charger Scrutiny & Sealing Scrutineering Scrutineering Friday 22 nd June hrs Rally Headquarters Opens Distribution of Books, Service Guide, Door Numbers and Sponsor Advertising, for country competitors) Rally Headquarters hrs Reconnaissance Day 2 Robertstown 23 rd June hrs Rally Headquarters opens hrs Re-scrutineering 1000 hrs Competitors Briefing 1030 hrs Cars to Staging Area Saturday 1100 hrs 1929 hrs 2156 hrs First Car Starts First Car Due to Finish Last Car Due to Finish (50 cars) Rally Headquarters hrs Post Event Scrutineering 2200 hrs Provisional Results posted and Trophy Presentation 2300 hrs Rally Headquarters Closes Wednesday 18 th July hrs Awards Presentation Walkerville RSL Hall 4

5 II. GENERAL INFORMATION RALLY ENQUIRIES Scott Atkinson Mbl: Jeremy Browne Mbl: MEDIA ENQUIRIES Phil Williams Mbl: Simon West Mbl: CORRESPONDENCE: Address all correspondence to: The Event Secretary 2012 COPYWORLD Walky 100 PO Box 346 Nairne No responsibility will be accepted by the organisers for any correspondence sent to any other address OFFICIALS Greta Nason Mbl: RALLY OFFICE: 2012 COPYWORLD Walky 100 Main Office: 37 Addison Rd, Hove, SA, 5048 City Office for Book collection only: 37 Addison Rd, Hove RALLY HEADQUARTERS: Southern Saints Football Club Robertstown Oval South Australia OFFICIAL NOTICE BOARD: Up to and including Friday 22nd June 2012; And after the closure of Rally Headquarters. Then from 0700 hrs Saturday 23rd June 2012 the Notice Board will be in operation at Rally Headquarters during the conduct of the Rally. 5

6 Article 1. - ORGANISATION III. ORGANISATION 1.1 ORGANISATION AND PROMOTION The organiser and promoter of the 2012 COPYWORLD Walky 100 is the Walkerville All Cars Club Inc. Whilst the core organising team has been selected from the WACC, all of the following clubs are represented in various positions: Walkerville All Cars Club Inc Southern Districts Car Club Inc Rallysport Car Club of South Australia Inc ACRM The 2012 COPYWORLD Walky 100 will be a State Championship Special Stage Rally, run under the provisions of the International Sporting Code of the FIA, the National Competition Rules (NCR) of CAMS, the National Rally Code, 2012 SA Conditions of Rallying, 2012 SARC Series Supplementary Regulations, these Event Supplementary Regulations and any authorised further regulations and Bulletins. 1.2 OFFICIALS OF THE RALLY CAMS Stewards of the Meeting Course Checker Robert Whyatt Adrian Flynn Mark Warner Jason Lange 1.3 ORGANISING COMMITTEE Clerk of Course Deputy Clerk of Course Secretary Officials Coordinator Media / Public Relations Results Manager Scott Atkinson Mobile: copyworldwalky100.coc@wacc.asn.au Licence: No Jeremy Browne Mobile: copyworldwalky100.dcoc@wacc.asn.au Licence: No Kimberley Franklin Mobile: copyworldwalky100.secretary@wacc.asn.au Licence: No Greta Nason Mobile: copyworldwalky100.officials@wacc.asn.au Licence: No Phil Williams Mobile copyworldwalky100.media@wacc.asn.au Jim Penhale copyworldwalky100.results@wacc.asn.au 6

7 Chief Scrutineer Competitor Relations Officer Compliance Checker Bob Nason Mobile: Lynette Marker Matt Monto Article 3. - EVENT DETAILS 3.3 The CAMS Permit Number authorising the event is 512/2306/ The length of the rally will be approximately 295 kms, including 12 stages which have a total competitive distance of approximately 116 kms. All special stages are of a gravel/dirt surface, held in the Regional Council of Goyder, on (closed) public & private roads. 3.5 The Event will consist of one Heat on one day. Article 6. - ENTRIES AND ENTRY FEE 6.1 Completed entries together with the appropriate fee as prescribed in Article 6.4 of these regulations should be sent to: The Event Secretary 2012 COPYWORLD Walky 100 PO Box 346 Nairne SA Entries open 0900 hrs on Monday 14 th May Final Entries close 2000 hrs on Thursday 7 th June The entry fee for the Event is fixed as follows: Registered SARC $ Non Registered SARC $ The entry fee includes CAMS Permit Fee CAMS SARC Trophy Fund CAMS Repair Fund One set of Books One Service crew registration One set of Service Crew Instructions One set of Spectator Instructions Medical Intervention Teams Payment may be made in: In Cash to the Event Secretary in person OR By Cheque / Money Order payable to Walkerville All Cars Club Inc OR By Electronic Funds Transfer (EFT) to: BSB Account No Account Name Walkerville All Cars Club Description / Reference <Competitor Name> IMPORTANT NOTE: The EFT Description / Lodgement Reference MUST be specified as the name of the competitor (ie. NOT Robertstown Rally or Walkerville All Cars Club). A written or printed receipt MUST be provided with the entry form for ease of processing. 7

8 Article 7. - SERVICING AND REFUELLING 7.1 The maximum distance between nominated Service Parks and refuel zones will be approximately 70.00km (including 31.00km competitive). 7.2 Fuel will be available at the following locations:- a - SAFF Eudunda has unleaded, Premium unleaded, Diesel and LPG. b - Robertstown Mobil has unleaded, Premium unleaded & Diesel (only open until 1200 hrs). Article 8. RECONNAISSANCE AND PACE NOTING 8.10 Reconnaissance will be available on either: Recce Day 1; Sunday 17 th June 2012 between 0800 hrs 1600 hrs. Recce Day 2; Friday 22nd June 2012 between 0800 hrs 1600 hrs. Article 9 ODOMETER CHECK As detailed in the 2012 SA Conditions of Rallying. There will also be a 5km check on the road approaching Robertstown and detailed in the Rally Route Instructions. Article DOCUMENTATION AND SCRUTINY IV. DOCUMENTATION & SCRUTINY 10.1 Documentation will be available during the following times and must be completed prior to presentation of that vehicle for scrutiny: Thursday 21st June 2012, 1900 hrs till 2030 hrs at Tyrepower St Agnes, 121 Tolley, St Agnes, 5097 SA, Phone: (08) OR, where approved, Saturday 23rd June 2012, 0700 hrs till 0900 hrs at Rally Headquarters, Robertstown Oval Vehicles must be presented for scrutiny on Thursday 21st June 2012 between 1900 hrs and 2200 hrs (unless granted an exemption by the Chief Scrutineer) at: Tyrepower St Agnes, 121 Tolley, St Agnes, 5097 SA. Failure to comply with these requirements will result in a time penalty being imposed at the discretion of the Stewards of the Meeting. Regional and interstate competitors must apply to the Chief Scrutineer, in writing, to have scrutiny undertaken by the appropriate scrutineering authority in their local area. These competitors must present their documentation along with the endorsed scrutiny pass form at the Scrutineering Marquee on Saturday 23rd June 2012, 0800 hrs till 0900 hrs. It s the crew s responsibility to present their apparel for checking on the day, before 0900 hrs Vehicles requiring re-scrutiny, or those vehicles granted an exemption from Article 10.2 are required to attend scrutiny at Scrutineering Marquee, Robertstown Oval on Saturday 23rd June 2012, 0800 hrs till 0930 hrs Turbo Scrutiny will be held for all vehicles fitted with a turbocharger on Thursday 21st June 2012 during normal process at the scrutiny venue, listed in Vehicles granted exemption from Article 10.2 will be scrutineered as per Article 10.3 Article START V. RUNNING OF THE RALLY 11.1 Both driver and co-driver MUST be present at the Competitors briefing at 1000 hrs on Saturday 23rd June 2012 at Rally Headquarters. Non attendance will be reported to the Stewards and the recommended penalty will be exclusion The Rally will start at 1100 hrs on Saturday 23rd June 2012 and the first car will finish at approx 8

9 1930 hrs at Southern Saints Football Club, Robertstown Competing Vehicles are required to be placed in the Staging area (refer to the road book) no later than 1030 hrs. It is not necessary that a member of the crew is the person who places the vehicle in the staging area. In accordance with the above regulations, a map of the location and directions will be provided to competitors in the road books Late arrival See Series Regulations 11.5 Cars will start special stages at 2 minute intervals until SS6. From the second regroup, the interval may be adjusted to suit the weather conditions at the time Special Stages will be closed to competition when the slow sweep enters the stage. Any crew who arrives at a special stage time control within their late time limit but after the stage has closed to competition, are to drive the stage abiding by all applicable road regulations. A derived time considered by the stewards to be fairest will be given to the crew. Crews are to enter their own start and finish times on the time card if the control officials have packed up and/or have left the control area. Any crew that stops on a stage and is passed by the sweep is deemed to have withdrawn from that stage. Article 16 PRIZES, TROPHIES AND AWARDS VI. AWARDS 16.1 The Trophy Presentations based on provisional results will be held at Saturday 23rd June 2012, 2200 hrs at Rally Headquarters, Robertstown Oval (will be earlier if possible) The Revolution Racegear Award will be advised via a bulletin Walkerville All Cars Club Inc Member Awards: The Walky 500 Trophy shall be presented to the highest placed crew who are both financial members of the Walkerville All Cars Club Inc at the close of entries. The award will be presented at the A.G.M. in December. Article RESULTS See Series Regulations. Provisional and final results will be posted on the official 2012 COPYWORLD Walky 100 Website: 9

10 Section Location Section Distance VIII. ITINERARY Stage Distance Time Allowed Closed 1st Competitor Last Competitor TC :00 12: TC :12 12:30 Open SS1 One Big Hill :15 11:15 12:33 16:00 TC :15 12: TC :47 13:05 SS2 Eagle Hawk :45 11:50 13:08 16:30 TC :50 13: TC :09 13:27 SS3 Hallelujah Range :50 12:12 13:30 16:45 TC :12 13: TC 1.3A 12:31 13:49 Competitive Liaison Total REGROUP A 15 Minutes Section Location SERVICE A 20 Minutes Section Distance Stage Distance Time Allowed Closed 1st Competitor Last Competitor TC 1.3C 13:06 14: TC :21 14:39 Open SS4 One Big Hill :15 13:24 14:42 16:00 TC :24 14:42 TC :56 15:14 SS5 Eagle Hawk :45 13:59 15:17 16:30 TC :59 15: TC :18 15:36 SS6 Hallelujah Range :50 14:21 15:39 16:45 TC :21 15: TC 1.6A 14:40 15:58 Competitive Liaison Total REGROUP B 0:20 HH:MM * FIELD CHANGES TO 3 MIN GAP SERVICE B 0:30 HH:MM The information on this page is based on 40 Cars at 2 minute intervals. Please check the website and the roadbook for updates: 10

11 Section Location Section Distance Stage Distance Time Allowed Closed 1st Competitor Last Competitor Open TC 1.6C 15:30 17: TC :50 17:35 SS7 Julia Who? :00 15:53 17:38 21:00 TC :53 17: TC :18 18:03 SS8 Wayne Who? :30 16:21 18:06 21:30 TC 1.8 TC :21 16:41 18:06 18:26 SS9 Roast :00 16:44 18:29 22:00 TC :44 18: TC 1.9A 17:10 18:55 Competitive Liaison Total REGROUP C 0:15 HH:MM SERVICE C 0:20 HH:MM Section Location Section Distance Stage Distance Time Allowed Closed 1st Competitor Last Competitor TC 1.9C 17:45 19: TC :05 19:50 Open SS10 Julia Who? :00 18:08 19:53 21:00 TC :08 19: TC :33 20:18 SS11 Wayne Who? :30 18:36 20:21 21:30 TC 1.11 TC :36 18:56 20:21 20:41 SS12 Roast :00 18:59 20:44 22:00 TC :59 20: TC 1.12A 19:25 21:10 Finish & Parc Ferme 19:25 21:10 Competitive Liaison Total Event Totals Competitive Liaison Total The information on this page is based on 35 Cars at 3 minute intervals. Please check the website and the roadbook for updates: 11

12 Please place a tick for each Event you are entering Version February 2007 ENTRY FORM 2012 COPYWORLD Walky 100 Saturday 23rd June 2012 Held under the International Sporting Code of the FIA and the National Competition Rules of CAMS Permit 512/2306/01 SA Rally Champ. Recce Day: Sunday 17 th June or Friday 22nd June COMPETITOR (CAR OWNER) Name: Address: Postcode: Telephone: Mobile (hm) (wk) CAMS Licence: Number: Expiry Date: DRIVER Name: Address: Date of Birth: Postcode: Telephone: (mobile) (hm) (wk) Civil Licence Number: Club: Club Member No: CAMS Licence Number: Type: CR NR NRJ Expiry Date: Emergency contact Person: Name: Emergency contact Person: Name: Mobile: Mobile: CO- DRIVER / NAVIGATOR Name: Address: Date of Birth: Postcode: Telephone: (mobile) (hm) (wk) Civil Licence Number: Club: Club Member No: CAMS Licence: Number: Type: CR NR NRJ Expiry Date: Emergency contact Person: Name: Emergency contact Person: Name: Mobile: Mobile: Entry Form Page i of viii

13 VEHICLE DESCRIPTION Version February 2007 Make: Model: Year: Body Type: Registration Number: Reg. Expires: Colour: Logbook No: Class: PACENOTING VEHICLE REGISTRATION DESCRIPTION OF CAR Make: Model: Year: Colour: Registration Number: Reg. Expires: SERVICE CREW REGISTRATION DESCRIPTION OF CAR 1 Make: Model: Year: Colour: Registration Number: Reg. Expires: SERVICE CREW REGISTRATION DESCRIPTION OF CAR 2 Make: Model: Year: Colour: Registration Number: Reg. Expires: Signature Date Competitor Driver Co-Driver/Navigator Enclosed is CASH / CHEQUE / MONEY ORDER / EFT Receipt for the sum of $.... being entry fee for the event. OFFICIAL USE ONLY SARC Date Received...Time Received...Entry form fully Completed (Yes / No). Amount Paid $. Payment Details cheque / money order / cash / EFT CAMS Licence CAMS Passbook Club Membership Disclaimer U18 Disclaimer Navigator Only Disc. Service Crew Car 1 Service Crew Car 2 Extra Book Entry Form Page ii of viii

14 Version February 2007 DISCLAIMER EXCLUSION OF LIABILITY, RELEASE AND ASSUMPTION OF RISK COMPETITORS AND/OR COMPETING CREWS AND/OR SERVICE CREW IN RALLIES For Competitors I/We being the competitor/s of the vehicle described on this Entry Form wish to enter that vehicle for the above event. For Competitors and competing crew/ and service crew I/We being the competitor/s and/or driver and/or co-driver and/or navigator and/or service crew, certify that the particulars on this form are true and correct in every particular, to the best of my/our knowledge and belief. I/We declare that I/we have read and understood the Supplementary Regulations issued for the event, and agree to be bound by them and the provisions of the National Competition Rules of the Confederation of Australian Motor Sport Limited ( CAMS ). In exchange for being able to attend or participate in the event (including entering the event), I agree: to release CAMS and Australian Motor Sport Commission Ltd, promoters, sponsor organisations, land owners and lessees, organisers of the event, their respective servants, officials, representatives and agents (collectively, the "Associated Entities") from all liability for my death, personal injury (including burns), psychological trauma, loss or damage (including property damage) ("harm") howsoever arising from my participation in or attendance at the event, except to the extent prohibited by law; that CAMS and 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; and to attend or participate in the event at my own risk. I/we acknowledge that: the risks associated with attending or participating in the event include the risk that I may suffer harm as a result of: o motor vehicles (or parts of them) colliding with other motor vehicles, persons or property; o acts of violence and other harmful acts (whether intentional or inadvertent) committed by persons o attending or participating in the event; and the failure or unsuitability of facilities (including grand-stands, fences and guard rails) 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. the route instructions should not be relied upon exclusively in estimating the degree of severity of any hazard which might be encountered, or the manner in which any section of the road is driven, whether shown in the route instructions or not, and that I/We have been advised to exercise caution in following these route instructions. I accept the conditions of, and acknowledge the risks arising from, attending or participating in the event and being provided with the event services by CAMS and the Associated Entities. I/we acknowledge that my/our personal information will be processed in accordance with the CAMS privacy policy which is available from the and where I/we suffer from any injury, sickness or death during the Event, I/we consent to the release by health services of my/our personal health information to an authorised representative of CAMS or the Event who may use it in the preparation and release within and outside Australia of accident or incident information and reports to interested parties for the purposes of accident investigation, accident prevention and safety activities, news services including broadcast services, or for the purposes of processing insurance claims. I understand that this disclaimer is not intended to exclude any valid claim I may have under the CAMS Personal Insurance Scheme. Competitor's signature:....date:... Driver/s signature:... Date:... Navigator/Co-Driver/s signature:... Date:... For persons under the age of 18 years the following parent/guardian consent must be completed. PARENT/ GUARDIAN CONSENT PERSONS UNDER 18 YEARS OLD I of [Address] am the parent/ guardian* of the above-named ("the minor") who is under 18 years old. I have read this document and understand its contents, including the exclusion of liability and assumption of risk, and have explained the contents to the minor. I consent to the minor attending/ participating in* the event at his/her own risk. Signed Parent/Guardian* Delete whichever does not apply Date Entry Form Page iii of viii

15 For Service Crew DISCLAIMER EXCLUSION OF LIABILITY, RELEASE AND ASSUMPTION OF RISK RALLY SERVICE CREW DISCLAIMER I/We being a member of/the service crew certify that the particulars on this form are true and correct in every particular, to the best of my/our knowledge and belief. In exchange for being able to attend or participate in the event, I/we agree: To release Confederation of Australian Motor Sport Ltd ("CAMS") and Australian Motor Sport Commission Ltd, promoters, sponsor organisations, land owners and lessees, organisers of the event, their respective servants, officials, representatives and agents (collectively, the Associated Entities ) from all liability for my death, personal injury (including burns), psychological trauma, loss or damage (including property damage) ( harm ) howsoever arising from my participation in or attendance at the event, except to the extent prohibited by law: That CAMS and 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: and To attend or participate in the event at my own risk. That Service crew members must be over the age of 16 years. Where a person under 18 years is part of a service crew they require parental/ guardian consent and that crew member/s must be under adult supervision at all times. I/We acknowledge that: The risks associated with attending of participating in the event include the risk that I may suffer harm as a result of: o Motor vehicles (or parts of them) colliding with other motor vehicles, persons or property: o Acts of violence and other harmful acts (whether intentional or inadvertent) committed by persons attending o or participating in the event; and The failure or unsuitability of facilities (including grand-stands, fences and guard rails) 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. The route/service crew instructions should not be relied upon exclusively in estimating the degree of severity of any hazard which might be encountered, or the manner in which any section of the road is driven, whether shown in the route instructions or not, and that I/we have been advised to exercise caution in following these route/service crew instructions. I accept the conditions of, and acknowledge the risks arising from, attending or participating in the event and being provided with the event services by CAMS and the Associated Entities. I/we acknowledge that my/our personal information will be processed in accordance with the CAMS privacy policy which is available from the and where I/we suffer from any injury, sickness or death during the Event, I/we consent to the release by health services of my/our personal health information to an authorised representative of CAMS or the Event who may use it in the preparation and release within and outside Australia of accident or incident information and reports to interested parties for the purposes of accident investigation, accident prevention and safety activities, news services including broadcast services, or for the purposes of processing insurance claims. Entry Form Page v of vii

16 I understand that this disclaimer is not intended to exclude any valid claim I may have under the CAMS Personal Insurance Scheme. Name (print) Date Signed Name (print) Date Signed Name (print) Date Signed Name (print) Date Signed Name (print) Date Signed Name (print) Date Signed For persons under the age of 18 years the following parent/guardian consent must be completed. Note: 16 years is the minimum age for a member of the service crew. PARENT/ GUARDIAN CONSENT PERSONS UNDER 18 YEARS OLD I of [Address] am the parent/ guardian* of the above-named ("the minor") who is under 18 years old. I have read this document and understand its contents, including the exclusion of liability and assumption of risk, and have explained the contents to the minor. I consent to the minor attending/ participating in* the event at his/her own risk. Signed. Parent/Guardian* Date * Delete whichever does not apply Entry Form Page vi of vii

17 2012 COPYWORLD WALKY 100 MEDIA INFORMATION DRIVER CO-DRIVER Name Name Nick Name Nick Name Age Age Occupation Occupation Home Town State Home Town State Car Club(s) Car Club(s) Best Two Rally Results Most Spectacular Retirement Additional Info VEHICLE Make Year Model Class Drive RWD / FWD / 4WD Colour Capacity cc Modifications History of Car Other Info Sponsors Entry Form Page vii of vii

18 Form SR Declaration of co-driver without civil licence National Rally Code, Article 2.1 (iii) To be completed at Pre-Event Documentation I: CAMS Licence Number Of: In the state of: declare and agree that in accordance with the CAMS National Rally Code, Article 2.1(iii), I will not drive the car for which I am entered in the Event, being the: as I have not presented my civil licence at this time of pre-event documentation. Signature: Date: Print Full Name: Entry Form Page viii of vii