Motorsport Licensing & Event Insurance - Safety Cage Installer Registration

Details of person completing this application

First Name*

Last Name*

Email*

Phone*

Installer Details

Registered Name of Installer*

Installer Address 1*

Installer Address 2

City / Town*

State*

Postcode*

Installer Email*

Installer Phone*

Installer Contact Person

Installer ABN (if applicable)

Installer Website (if applicable)

Important

I/We wish to be registered with the AASA as an installer of safety cage structures.
I confirm that:

• I/we have access to, and have read, the AASA Safety Cage regulations
• I/We have sought/will seek clarification from the AASA on each matter that I/we do not fully understand
• I/We have access to tube bending machinery suitable for the construction of safety cage structures
• I/We have access to welding equipment suitable for the welding of safety cage structures
• I/We have access to persons having the skills and experience to construct safety cage structures
• I/We have access to persons having appropriate welding qualifications and/or relevant units of competency
• That each structure installed by me/us will be identified by the installer's name as above and a unique serial number permanently attached to the structure.
• That each structure installed by me/us and bearing my/our name and serial number will be suitable for the purpose of competition in motor sport activities.
• That each structure installed by me/us will be in compliance with the AASA Safety Cage requirements in place on the completion date of installation of the structure.

I confirm that i have read the above statements and agree to all*

Yes, I confirm

Payment

Coupon

AASA Safety Cage Installer Registration*

Price: $ 50.00

Total

$ 0.00

Credit Card*

MasterCard

Visa

Card Number Expiration Date Security Code Cardholder Name