2013 Surf Slam Online Entry Form
Date of Birth
Full address including postcode
Government PWC Licence Number
AJSBA Licence Number
All riders require a licence. If you do not have a licence you can purchase a day licence for $50.00.
AJSBA Competition Licence Expiry Date
AJSBA Rider Class
Freestyle. Krash Industries, Competition
Freestyle. Rip n Ride
Name and Phone Number
Superjet, SXR, Rickter etc.
PWC Owner's Name
ALL PWC to have current registration. It must also be displaying the correct Numbers and Rego label. Failure to comply will result in the ski being parked.
Registration Expiry Date
Hull ID number
What classes/events will you be entering?
Krash Industries Australian Freestyle Championships
Freestyle Queensland Rip 'n' Ride
How many people will be attending the prize-giving evening?
Adults/children are included in count
I won't be attending
AJSBA Code of Conduct
I have completely read and understand the AJSBA Code of Conduct at the link: http://www.qpwc.org.au/index.php?action=dlattach;topic=23.0;attach=27
AJSBA Liability Insurance for AJSBA Racing & Club Activities
I have completely read and understand the Liability Insurance at the link: http://www.qpwc.org.au/index.php?action=dlattach;topic=23.0;attach=25
I have completely read and understand the AJSBA event information details at the link: https://skydrive.live.com/edit.aspx?cid=2f3ed8685655b0f9&resid=2F3ED8685655B0F9!157&sc=documents
2011-2012 AJSBA Membership Licence Application
For all Membership and Licence information for the AJSBA please refer to the link: 2011-2012 AJSBA Membership Licence Application MB21.10.11.pdf
I have completely read and understand the AJSBA Declaration and Indemnity below
DECLARATION AND INDEMNITY 1. I the undersigned, in consideration or as a condition of acceptance of my entry in each event I participate in for myself, my heirs,executors, administrators, hereby waive all and any claim rights or course of action which I or they might otherwise have for or rising out of the loss of my life or injury, damage or loss of any description whatsoever which I may suffer in the course of or consequent entry ofparticipation in the said event. 2. This waiver release and discharge shall be and operate separately in favour of all persons, corporations and bodies involved or otherwise engaged in promoting or staging the said event and the servants, agents, representatives and officers or any of them and includes but is not limited to the committee of the Australasian Jet Sports Boating Association affiliate host club (the organisers of the event) medical and paramedical practitioners and personal police officers, shire councils and shall operate whether or not the loss, injury or damage is attributed to the act or neglect of one or more of them. 3. I hereby indemnify the committee, the affiliate host club and its members and the Australasian Jet Sports Boating Association against all suits, claims and demands whatsoever arising out of my participation in the said event. 4. I declare that I will abide by the event rules and will accept the organiser’s decision as final. I acknowledge that this declaration and indemnity applies to the participation of the above named in the said event. 5. I agree to uphold the rules outlined in the I.J.S.B.A rulebook.
I have read and understand the AJSBA Declaration and Indemnity above
I have read the Declaration and Indemnity
Please Pay Online to save time and paperwork at the event.
Entry Fee is $200.00 per person. This includes entry to the Krash Industries Australian Freestyle Championships and Qld Rip. The price is the same if you are riding one or two days or in one or two classes. Price is inclusive of $50.00 AJSBA Licence fee and Presentation dinner. $30.00 for each additional adult or child who wants to attend the Presentation. (includes food.) Additional food and drink are available for purchase. Please direct deposit to Sunshine Coast Jetsports Club BSB # 484 799 Acc # 031027590 and use your name as a reference. Your entry will not be accepted until the full payment is recieved. If you would like to confirm your entry or how much you need to pay please email firstname.lastname@example.org and I will be happy to help.
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