Passenger Indemnity: South Island Champs 2020

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You do not need a Passenger Wristband if you are a registered Driver.



Passenger wristband donation is seperate to Spectator gate entry fee.

Passenger Details

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Emergency Contact Details


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Passenger Indemnity Details

I, the undersigned, hereby confirm and warrant and agree to be bound by the following terms and conditions in favour, and for the benefit of, LR (Levels Raceway), All Employees of Levels Raceway, 4 & Rotary and Premier Events:

1. I will comply with the Occupational Safety and Health Regulations provided to me by LR, 4 & Rotary and Premier Events at all times.

2. I will at all times comply with the instructions from LR, 4 & Rotary and Premier Events employees and agents.

3. I will exercise all due care and will at all times comply with the Safety Regulations of Levels Raceway.

4. I understand that the LR Circuit Manager or any of their employees or agents may terminate and prohibit my access to the facility if I breach any of the terms in this indemnity form.

5. I will be responsible for and will pay to make good any damage I may cause, whether deliberately or otherwise, to any property of Levels Raceway.

6. I will not hold HLR, 4 & Rotary and Premier Events responsible for any damage, injury or death caused by mechanical failure or otherwise of any vehicle supplied by those parties, whether directly or through a sub-contractor, or due to the state of Levels Raceway.

7. I understand that in consideration of LR granting me permission to use the circuit I warrant all of the above and will indemnify LR, 4 & Rotary and Premier Events  and together with their employees, directors, officials, representatives and agents from and against all actions, claims, costs, expenses and demands in respect of death, injury, loss or damage to person or property however caused, arising out of or in connection with my use of a vehicle and the LR Circuit, including claims by third parties, notwithstanding that such claims may have been contributed to by the fault or negligence of LR, 4 & Rotary and Premier Events .

8. Age restrictions & Children: We do not recommend kids under 5 years of age to join as passengers. Children/Minors (Below 18 years of age by the date of the event) who will be joining as passengers are a responsibility of the parent/guardian. Normal road rules apply for children who are traveling in the car as passengers. (Car seat and other safety requirements).

By filling out this form, you can now purchase your Passenger Wristband on the day for a $10 donation for the whole weekend. (Cash ONLY, Please bring exact change as it goes in to a sealed donation box). No paperwork will need to be filled out on the day if you've filled out this form.

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Note: After clicking the SUBMIT button you should see a new screen saying Thank You, if you still see your form please check for errors and make sure all boxes are ticked.

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