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INDIA NON JUDICIAL

Of K arnatclJ!@.
Governm,_nt
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Certificate No.
IN -KA81041669483554V
Certificate Issued Date
13-Feb-2023 04:46 PM AR / KA-RM
Account Reference 6
NONACC (Fl)/ kagcsl08/ RAMANAG
Unique Doc. Reference
SUBIN-KAKAGCSL08528 15 5 19ZOV ooz o
Purchased by
MUBARAK PASHA
Description of Document
Article 29 Indemnity Bond
Description
INDEMNITY BOND
Consideration Price (Rs.)
0
(Zero)
First Party
MUBARAK PASHA
Second Party
ACES OF SPEED INDIA PVT LTD
Stamp Duty Paid By
MUBARAK PASHA
Stamp Duty Amount(Rs.)

3
:,:

3
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.... ... ............ .............. .........•................................ Please w rite or type below th is line ';'
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Aces of speed India Pvt Ltd - Round 1

I/we, the undersigned MUBARAK PASHA hereby make an application to participate in

the "Aces of Speed India Pvt Ltd-Round 1" and certify that the particu!ars of my vehicle as
stated in the application forms are correct and further that I have rea~ -the Regulation issued by
the Organizers for the event. I DO AGREE TO BE BOUND by these regulations.

No t)Y C0rrect1ons.•.,..!.-
!'J/ v
Statutory Alert: . ·ri should be verified at 'www .shcilesta mp.com' or usin -s .
1
i';b8
_ The authenticity ~f this ~t~IT)fs ~ ~h1 ertificate and as available on the website I Mobile Ap~ ;enJ~~P}~ob11~ App of Stock Holding.
Any discrepancy I~ the e a1~i~ a is on the users of the certificate. s ' mvalrd .
2. The onus of checking the legl cy f m the Competen t Authority.
3. In case of any discrepancy p ease in or
DECLARATION
I/We have read the Regulations Issued for this event and agree to abide by them in consideration of the acceptance of the

entry of this vehicle.

I agree to save harmless and keep indemnified the Government of Tamil Nadu, Government of India, the FMSCI, the FIM / FIA
(whichever is applicable\, the organizers Aces of Speed India Pvt Ltd •. , the promoters, the sponsors and their offlclals, agents,
representatives, employees and all persons assisting In this event and all owners and tenants of private property traversed
from and against all actions, claims, costs, expenses and demands In respect of death, lnJurv to myself or any other persons or
•ass or damagc to any property including the vehicle concerned In this event or otherwise howsoever and notwithstanding that
the same may have been contributed to or occasioned by the negligence of the organizers and their officials, agents,
representatives, employees and all persons assistinc them in this event.
l he indemnity shall be binding on my hcirs, executors, administrator$ and legal representatives.
I/We agree and undertake not to agitate, litigate or seek a decision of a court of law _on any matter or question concerning or
relating to the drag coming from the submission of the entry form up to the conclusion of the declaration and distribution of
prizes. I also renounce and relinquish my rights, if any, to have recourse to any arbitrator, tribunal not provided for In these

Supplementary Regulations.
I/We am/are aware that FMSCI Competition License covers INR 51.;)kh toward medical expenses (FULL CLAIM UPTO Rs.3 LAKH
& 90% FOR REMAINING Rs.2 LAKH) Any Addltlonal claim arising from an Incident wlll be my responsibility and organizers, co·

organisers, promoters, FMSCI, FIM, FIA wlll not be responsible for ttie same,
Finally, I/We, hereby, acknowledge that I/We am/are conversant with the risks and dangers of motor sport In general and this
event in particulilr, for which I, hereby, assume to be solely responslble. I/We, hereby, confirm that I/We have my accident
policy with hospitalization and hence organlz~rs are not responsible.
I/We also understand and confirm the onus of proving authenticity & legality of entry form, documents / vehicle papers
submitted by me and the vehicle's legalities will be my responsibl\lty. The organisers/ promoters/ the event officials will not

be liable or responsible for the same.

I confirm that in case I am participating In single/ multiple races, then this Indemnity Is valid for any and all the races.

Place : f)orf d()bcd ,~pv h . I >)!! ,J/tJ ?

Date:

(Y'. .;). ~
Signatures of the Entrants: Rider/ Orlver __ ._.;;...;..----~_.;;c....----------------