ESP Competitor Declaration

I (the competitor)(Required)

of(Required)

Email(Required)

hereby state that I or my agent have inspected the vehicle against all items on this form and confirm that the entered vehicle complies with all relevant minimum personal protective equipment, vehicle and Class Eligibility requirements as detailed in the ANDRA Rulebook. The vehicle will be made available for Compliance Audits as requested by the appointed Officials.

Event Venue(Required)

Event Date(Required)

Licence No.(Required)

Eliminator(Required)

Class(Required)

Example SS/A, TS/A, S/STB etc.

Category One – Compliance Critical

Helmet

Protective Clothing

Safety Harness

Helmet Details

Safety Harness Details

Arm Restraints/ Window Net

Front Head Restraint

Roll Over Protection

Bellhousing/ Auto Trans Shield

Brakes

Cylinder/ Head Restraints

Clutch/ Chain Guard

Steering System

Suspension System

Seat and Mountings

Wheels/ Tyres

Fuel Shutoff

Throttle Return

Fire System

Supercharger Restraints

Wheelie Bars

Lanyard/ Ignition Kill

Technical Inspection

Parachutes

Category Two – Compliance Non-Critical

Engine & Transmission

Clutch & Flywheel

Neutral Safety Switch (Auto Trans)

Auto Trans Shifter

Battery/ Battery Mounting

Battery Isolation Switch

Fuel Tank/ Fuel Cell

Liquid Overflow

Lower Engine Containment Device

Lubrication & Cooling System

Firewall

Fuel Lines

Nitrous Oxide

Wing Mounts

Fire Extinguisher

Category Three – Class Compliance and Non-Critical

Engine Capacity & Components

Transmission Type

Body Dimensions & Aerodynamics

Licence Number & Class Displayed

General Vehicle Presentation

Fuel Blend

Fuel Blend Details

Supercharger Overdrive

Supercharger is Not Modified from OEM Specifications

Supercharger is ANDRA Approved Type Only

Supercharger Overdrive Details

Electronic Devices

No Reactive Control Devices Employed or Fitted

Fuel Additives

Fuel Additives Details

COMPETITOR DECLARATION: I am aware that where any breach of the Rules or Regulations of ANDRA is found during a Compliance Audit I render myself liable to Tribunal Action and/or appropriate penalties and my signature below indicates my acceptance of this undertaking.

Competitors Signature(Required)

Date(Required)

NOTE:Parent/ Guardian to complete form and sign competitor declaration on behalf of competitors under 18 years

Parent/ Guardian Signature

Date

Once this form is submitted you will receive a copy to your email. Please ensure you have a copy of this available to show if requested at sign in.