Montana Cross Country “ T” Association

2017 Endurance Run And Low Land Tour Waiver & Self Inspection Agreement

Owner Name ________________________________________________________________________________
Address ____________________________________________________________________________________
Phone number _______________________________________________________________________________
As a participant in the Montana 500 Cross Country Endurance Run and Low Land Tour Event,you must inspect your car prior to attending Run and Tour Event to complete event registration. Please check each of the categories with a “Y” for yes, “N” for no. The responsibility for car’s safety and and mechanical condition rests with the owner/participant/operator. Return at event signed. _______________________________________
Steering Steering wheel should have less than 2” to no play
Acceptable wear and minimal to no play
* Radius rod (wish bone) to crankcase
* Ball arm (pitman arm) to steering gear connecting rod (drag link)
* Steering gear connecting rod (tie rod) to yoke ball
*Spindle bolts (king pin)
*Spindle connecting rod (tie rod) bolts

Cotter keys (or lock washers, if holes not drilled) installed in the following:
*Radius rod (wish bone) to front axle (2 required)
*Steering gear bracket to frame ( 3 required )
* Ball arm ( pitman arm ) to steering post ( 1 required )
* Steering gear connecting rod (tie rod ) to yoke ball ( 2 required
* Steering gear connecting rod (tie rod ) to steering gear ball ( 2 required )
* Spindle connecting rod to spindles (2) (1 per spindle)
* Spindle bolts ( kingpins) 2 ( 1 spindle)
* Spindle arm 2 (1 per spindle)
* Front spring hangers (shackles) 4 (2 per side)
* Front spring to frame (2 or 4 required) depending on year
* Yoke ball (1 required)
* Safety wire crankcase studs holding radius rod ball cap
* Grease in steering gear case & steering gear bracket (also check gear post & pinion gears for wear)
* Check for play in steering gear case to steering column (check rivets/taper pins)

Brakes
Brake pedal (and, reverse pedal) bottom out before reaching floor boards
Both rear wheels lock up under hard braking

Emergency Brakes
Hand brake sets securely before limit of its travel (check pawl & spring) & both wheels lock
Note: The hand brake must be able to hold the car with engine running & should be able to hold the car on a moderate slope.
Cotter keys (or lock washers, if holes are drilled installed on:
* Control shaft assembly to frame (4 required)
* Brake shoe bolt 2 (1 per side)
* brake rods 4 (1 per end)

Wheels
Spokes (& felloes on earlier) cars are tight
Front wheel bearings-no play, good condition & greased
All wheels tight & axle/spindle nuts cotter keyed
Lug nuts tight on demountable rims
Checked tires for wear, weather cracks, rim cuts, ect. Page 1 of 2

Rear Axle
Rear axle nuts tight & secured with cotter pins (use long wrench)
Cotter keys (or lock washers, if holes are not drilled) installed:
*Rear spring to frame (4 required)
* Rear spring hangers (shackles) 4 (2 per side)
* Rear spring perches to wheel flanges (backing plates) 1 (per side)
Other
Lights functional
Brake light
Safety glass
Rear view mirrors
Fire extinguisher /first aid kit (optional but recommended)
Registration & insurance papers
Vehicle Data
year_____ body style_____ identification #____ license plate_____________
Insurance Information
Company _______________ Date of expiration__________ Policy #_______________

Waiver/Certification
In consideration of my being permitted to enter my vehicle on the subject tour and all of the related activities sponsored by the Montana Cross Country T Association I hereby certify that:
*I inspected my vehicle as noted and believe it to be roadworthy.
* I understand the inspection items/listings contained on this form are compiled from sources believed to be reliable but are not completely inclusive of all areas and items that should be checked or that could cause safety concerns. No warranty, guarantee or representation is made by the Montana Cross Country Association as to the absolute correctness or sufficiency of any representation contained in this listing and the Montana Cross Country T Association assumes no responsibility in connection therewith, nor can it be assumed that all acceptable safety measures are contained in this listing or that inspection of other areas of the vehicle or additional accessories may be required under particular exceptional condition or circumstances for safe operation.
* I certify that I have insurance coverage on the vehicle that covers my liability and physical damage as required in my state of residence.
I release and hold harmless the subject tour host officers, directors and members and the Montana Cross Country T Association from any liability of any kind whatsoever as a result of any personal injury or property damage sustained by the under signed.
Owner/entrant_______________________________________Date________________ Page 2 of 2