SELF DECLARATION

PMSC RALLY CROSS SELF DECLARATION 2021
Submitting this form attests that the Vehicle is safe and suitable for competition. Event Officials can check these and any other aspects of vehicle or drivers for safe operation at anytime

Driver Information

Driver Name (First and Last) *

Valid Drivers License? *

YesNo
Shared Vehicle? *

YesNo

For all shared vehicles, only one Self Declaration Required for all driver entrants

Shared Drivers (please list names of all other drivers sharing this vehicle)


YesNo

Helmet Snell

Helmet Snell*
SA 2005M 2005SA 2010M 2010SA 2015M 2015SA 2020M 2020

Insert word Checked for all checked items

Seat Belts in working order *

No Loose Items in car*

Battery Tie Down tight and battery secure *

Wheel Nuts Torqued to Specs *

Tow Points Front and Rear *

Vehicle Panels secure *