Montana Cross Country “T” Association

2018 Endurance Run Waiver & Self Inspection Agreement

Owner Name _______________________________________________________________________
Address _______________________________________________________________________
Phone number ______-_____-_________ Email: ___________________________________________
To participant in the Montana Cross Country Endurance Run, you must inspect your car prior to participating in the event at registration. Please check each of the categories with a “Y” for yes, “N” for no. The responsibility for the car’s safety and mechanical condition rests with the owner/participant/operator. Return waiver form at registration 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.

• 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/CertificationIn 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_________________