ALL APPLICANTS MUST AGREE AND SIGN OR ACCEPT THE MEMBERSHIP APPLICATION AND EVENT ENTRY FORM 

USE OF MOTOR VEHICLES/ VESSELS CAN BE DANGEROUS AND MAY INVOLVE INJURY OR DEATH

DECLARATION

1. THE ANSWERS GIVEN BY ME IN THIS MEMBERSHIP APPLICATION ARE TRUE.

2. I FULLY UNDERSTAND THE TYPE OF EVENTS WHICH THE MEMBERSHIP ALLOWS ME TO ENTER AND THE GUIDELINES, REGULATIONS AND RULES THAT APPLY TO SUCH EVENTS AND TO PARTICIPANTS AND WILL COMPLY WITH THEM.

3. I WILL ENSURE THAT BEFORE I ENTER ANY EVENT I AM COMPETENT AND THAT ANY VEHICLE/ VESSEL I USE IS SAFE AND FIT FOR PARTICIPATION AND THE NATURE OF THE COURSE.

4.  I WILL SATISFY MYSELF BEFORE TAKING PART IN ANY EVENT THAT THE VENUE IS ACCEPTABLE TO ME WITH REGARD TO ITS FEATURES AND PHYSICAL LAYOUT AND THAT I AM SATISFIED THAT IT IS SAFE FOR ME TO TAKE PART.

5. I WILL NOT ENTER OR TAKE PART IN ANY EVENT WHERE I HAVE DOUBTS AS TO MY SAFETY.

6. I WILL INFORM THE AMA IMMEDIATELY AND IN WRITING IF, FOR ANY REASON I BELIEVE THAT I AM NO LONGER ABLE TO SATISFY THE TERMS OF THIS MEMBERSHIP OR I BECOME AWARE THAT I HAVE BECOME UNABLE TO PARTICIPATE DUE TO A PHYSICAL OR OTHER DISABILITY.

7. THAT THERE IS AN INHERENT RISK OF INJURY OR DEATH BY PARTICIPATING IN MOTOR VEHICLE/ VESSEL EVENTS.

8. I AM NOT TAKING DRUGS (PRESCRIBED OR OTHERWISE) OR OTHER MEDICATION NOR DO I HAVE ANY MEDICAL CONDITION, AMPUTATION / LOSS OF LIMB OR IMPAIRED VISION THAT ADVERSELY AFFECTS MY ABILITY TO PARTICIPATE SAFELY OR COMPROMISES THE SAFETY OF OTHERS

9. AS THE PARTICIPANT, I WILL READ AND ABIDE BY THE AMA REGULATIONS AND RULES AND CONDITIONS OF ENTRY FOR EACH EVENT.

10. IN THE EVENT I AM INVOLVED IN AN ACCIDENT AT AN AMA EVENT I WILL ALLOW MY PERSONAL DETAILS TO BE PASSED BY THE FIRST AID PROVIDERS TO AN EVENT OFFICIAL.

11. I UNDERSTAND MY MEMBERSHIP WILL NOT BE ISSUED UNTIL AMA AUTHORISATION HAS BEEN RECEIVED.

12. I UNDERSTAND THAT PAYMENT WILL BE PROCESSED IMMEDIATELY BUT MY MEMBERSHIP WILL NOT BE RECEIVED UNTIL AMA APPROVAL IS RECEIVED.

MEDICAL DECLARATION

1. DO YOU SUFFER FROM EPILEPSY, FITS, BLACKOUTS OR ANY OTHER CONDITION WHICH MAY CAUSE LOSS OF CONSCIOUSNESS

2. DO YOU SUFFER FROM ANY CONDITION WHICH MIGHT CAUSE DIZZINESS, VERTIGO OR LOSS OF BALANCE

3. HAVE YOU EVER BEEN UNCONSCIOUS BECAUSE OF A HEAD INJURY OR SUFFERED A CONCUSSION IN THE LAST 12 MONTHS

4. IF YOU HAVE SUFFERED A CONCUSSIVE INJURY WITHIN THE LAST MONTH YOU SHOULD SEEK MEDICAL ADVICE BEFORE COMPETING IN AN AMA EVENT.

5. DO YOU SUFFER FROM ANY PROGRESSIVE NEUROLOGICAL DISORDER SUCH AS MULTIPLE SCLEROSIS OR MOTOR NEURONE DISEASE

6. HAVE YOU EVER SUFFERED A STROKE AT ANY TIME

7. DO YOU SUFFER FROM LOSS OF STRENGTH, LOSS OF FEELING, LOSS OF CONTROL OR LOSS OF MOVEMENT ON ANY OF YOUR LIMBS, HEAD OR NECK

8. HAVE YOU SUFFERED AN AMPUTATION OF ANY OF YOUR LIMBS OR PARTS OF LIMBS

9. DO YOU HAVE ANY ARTIFICIAL LIMBS

10. HAVE YOU EVER HAD A SURGICAL PROCEDURE FOR A HEART CONDITION (E.G. BYPASS, ANGIOPLASTY, PACEMAKER FITTED)

11. HAVE YOU BEEN DIAGNOSED WITH ANY KIND OF TUMOUR OR CANCER

12. DO YOU SUFFER FROM ANY CONDITION AFFECTING THE MAIN ARTERIES (E.G. BYPASS, GRAFT, AORTIC ANEURYSM)

13. HAVE YOU BEEN DIAGNOSED WITH DIABETES

14. DO YOU SUFFER FROM ANY PSYCHIATRIC OR EMOTIONAL ILLNESS

15. DO YOU SUFFER FROM HYPERTENSION (HIGH BLOOD PRESSURE)

16. DO YOU SUFFER FROM ANY CONDITION OR DISEASE AFFECTING YOUR EYES OR EARS

17. DO YOU SUFFER FROM OR ARE YOU ENGAGED IN ALCOHOL, DRUG, OR SUBSTANCE MISUSE

18. IF YOU HOLD AN AUSTRALIAN TRANSPORT AUTHORITY DRIVERS LICENCE (WHETHER FULL OR PROVISIONAL) IS THERE ANY REASON FOR MEDICAL RESTRICTIONS TO BE IMPOSED UPON IT

IF IN ANY DOUBT PLEASE CONTACT THE AMA OFFICE BEFORE PROCEEDING.

PARENT(S)/ GUARDIAN(S) AGREEMENT FOR MEMBERSHIP APPLICANTS AGED UNDER 18

1. I HAVE READ THIS APPLICATION FOR AN AMA  MEMBERSHIP AND CONFIRM THE TRUTH OF THE APPLICANT’S ANSWERS.

2. I CONFIRM THAT THE APPLICANT IS COMPETENT TO PARTICIPATE IN EVENTS OF THE TYPE TO WHICH THEIR ENTRIES RELATE AND THAT MOTOR VEHICLES/ VESSELS ENTERED WILL BE SUITABLE, SAFE AND WILL COMPLY WITH THE RULES FOR THOSE EVENTS.

3. I WILL ENSURE THAT THE APPLICANT COMPLIES WITH THE DECLARATION WHICH THEY ENDORSE AND WILL SATISFY MYSELF AS TO THE SAFETY OF THEIR MOTOR VEHICLE/ VESSEL AND THE SAFETY OF THE VENUE BEFORE ALLOWING THEM TO TAKE PART.

4. I CONFIRM THAT THE APPLICANT DOES NOT SUFFER FROM ANY PHYSICAL, MEDICAL OR OTHER DISABILITY THAT WOULD MAKE IT UNSAFE FOR THEM TO PARTAKE AS A PARTICIPANT OR COMPROMISE THE SAFETY OF OTHERS.

5. I ACCEPT THAT IT IS MY RESPONSIBILITY TO ENSURE THAT THE APPLICANT READS AND UNDERSTANDS THE AMA CODES, STANDING AND EVENT REGULATIONS AND FINAL INSTRUCTIONS SUBSEQUENTLY ISSUED AND ENTRY FORMS AND THAT THE APPLICANT WILL COMPLY WITH THEM.

6. DURING EVENT PROCEEDINGS ENTERED INTO BY THE APPLICANT, HE / SHE WILL BE ACCOMPANIED BY A PARENT / LEGAL GUARDIAN.

7. I ACCEPT AND AGREE THAT PHOTOGRAPHS OR VIDEO FOOTAGE MAY BE TAKEN OF THE APPLICANT BY OFFICIALS DEALING WITH SAFETY ISSUES OR ACCIDENT INVESTIGATIONS. I ACCEPT AND AGREE THAT PHOTOGRAPHS MAY ALSO BE TAKEN FOR PROMOTIONAL PURPOSES AND MAY APPEAR ON THE AMA WEBSITES OR IN PRESS RELEASES AND LITERATURE.

8. I HAVE READ AND UNDERSTOOD THE ‘ACKNOWLEDGEMENT OF RISK OF MOTOR VEHICLE/ VESSEL USE’ ABOVE AND I CAN CONFIRM THAT THE APPLICANT AND I ARE AWARE OF THE DANGERS INHERENT IN MOTOR VEHICLE/ VESSEL USE, WHICH INCLUDE THE RISK OF DEATH, PERMANENT DISABLEMENT OR SERIOUS INJURY 

9. I CONFIRM THAT THE APPLICANT WILL ALWAYS HAVE A PARENT/GUARDIAN WITH THEM AT ANY AMA SANCTIONED EVENT

PRIVACY ACT