“QUICK-TECH” INSPECTION FORM

Car Make_____________Model___________Year____

Tires in GOOD condition (2/32" MIN) __________

Wheel cover REMOVED ________

Lug nuts torque properly ________

NO LOOSE OBJECTS in car ________

Brake Lights Operable _______

Appropriate clothing and footwear:________

(Long Sleeves, Long Pants – Preferably a non-synthetic fiber)

Rubber-Soled Shoes (NO OPEN TOE) __________

Helmet (NO MOTORCYLE HELMETS) ___________

(SNELL MA or SA 2005 or Later)

Inspectors Signature_______________________________

Date__________

DRIVER / PARTICIPANT CAR TECHNICAL INSPECTION CERTIFICATION & INDEMNITY

THE UNDERSIGNED HEREBY CERTIFIES THAT:

THIS TECH INSPECTION SUBMITTED TO CIRCUIT GRAND BAYOU, LLC IN CONNECTION WITH THE EVENT WAS PERFORMED BY THE UNDERSIGNED ON THE DATE LISTED BELOW.  THE FORM CORRECTLY AND ACCURATELY SHOWS THE CONDITION OF THE CAR IDENTIFIED BELOW ON THE DATE LISTED BELOW.  THE UNDERSIGNED HEREBY AGREES TO INDEMNIFY AND HOLD HARMLESS CIRCUIT GRAND BAYOU, LLC AS TO ANY AND ALL OCCURRENCES ARISING FROM ANY INCORRECT STATEMENTS CONTAINED IN THE FORM.  I UNDERSTAND THAT THE TECH INSPECTION PERFORMED ON THE AUTOMOBILE IS SOLELY FOR THE PURPOSE OF MEETING MINIMUM STANDARDS OF CAR PREPARATION FOR THIS EVENT.  NO WARRANTIES ARE IMPLIED OR EXPRESSED IN THE PASSING OR FAILING OF THE INSPECTION PERFORMED.  I RELEASE ANY INSPECTORS FROM ANY AND ALL LIABILITY ARISING FROM THEIR INSPECTION OF THE AUTOMOBILE.  I ACKNOWLEDGE THAT THE SAFE CONDITION AND OPERATION OF THIS VEHICLE IS ENTIRELY MY RESPONSIBILITY AS WELL AS ANY VEHICLE PROBLEMS, MALFUNCTION OR DAMAGE WHICH MAY OCCUR IN CONNECTION WITH THE OPERATION OF THIS VEHICLE PRIOR, DURING OR SUBSEQUENT TO THIS EVENT.

DRIVER'S Name (Print)______________________________

DRIVER'S Signature_ _______________________________