ROOF 2011 SCRUTINEERING FORM Permit # 11763

NUMBERS
SPONSORS DECALS
HELMET STICKER ON LEFT SIDE HELMET
BALL ENDED CLUTCH & BRAKE LEVERS
KILL SWITCH
SPOKES
WHEEL BEARINGS
TYRES & RIMS
EXHAUST / SILENCER SECURE
KICK START
OPERATING BRAKES
SELF CLOSING THROTTLE
MUDGUARDS
NO FUEL LEAKS
FOLDING FOOTPEGS
ONE LITRE DRINKING FLUID
SPACE BLANKET
MEDICAL BOARD
PENCIL & PAPER
HELMET
UPPER BODY ARMOUR
MOTOCROSS TYPE PANTS
MOTOCROSS TYPE BOOTS
I AGREE WITH DECLARATION BELOW	MUST SELECT I AGREE
DECLARATION / UNDERTAKING OF COMPLIANCE IN ACCORDANCE WITH GCR 93 (iii)     I      (Rider / Entrant)  hereby give the above detailed undertaking of compliance of my motorcycle/quad with all the  technical specifications for Off Road Motorcycles & Quads, current at the time of entry,  and in addition the safety & environmental requirements, including those that refer to  protective and safety apparell for the riider

DECLARATION / UNDERTAKING OF COMPLIANCE IN ACCORDANCE WITH GCR 93 (iii) I _______________________________________ (Rider / Entrant) hereby give the above detailed undertaking of compliance of my motorcycle with all the technical specifications for Off Road Motorcycles current at the time of entry, and in addition the safety & environmental requirements, including those that refer to protective and safety apparell for the rider DATE.......................................... SIGNATURE...................................