The Montana 500

2019 Montana 500 Endurance Run Waiver & Self Inspection Agreement

Owner Name: _______________________________________________________________________

Address: _____________________________________________________________________________

Phone number: _______________________________________________________________________

As a participant in the Montana 500 Cross Country Endurance Run, you must inspect your car and sign this document prior to participating. Check mark each circle next to the item for compliance. The responsibility for car’s safety and mechanical condition rests with the owner/participant/operator. Return this completed and signed form to the head inspector.

  • Steering (Steering wheel rotation play should be less than 2 inches) 
    • Acceptable wear and minimal slight to no play 
    • * Radius rod perch (wish bone) at axle no play, at crankcase ball slight to no visible play 
    • * Steering gear ball arm (pitman arm) to steering gear connecting rod (drag link) slight to no visible play
    • * Steering connecting rod (tie rod) to yoke ball slight to no visible play
    • *Spindle bolts (king pin) slight to no visible play
    • *Spindle connecting rod (tie rod) bolts slight to no visible play 
    • * 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)
  • 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) 
    • * Steering gear ball arm (pitman arm) to steering post (1 required)
    • * Steering 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 per 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 securing radius rod ball cap 
  • 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 slight to 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, etc.
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  • 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
    • Headlights and taillight(s) functional 
    • Brake light functional 
    • Safety glass required 
    • Rear view mirror(s) required 
    • Fire extinguisher /first aid kit (optional but recommended) 
    • Current Vehicle Registration & Insurance papers required in car at all times
  • Vehicle Data
    • Year: _______ Body Style: _____________ Identification # _______________________ 
    • License Plate State _____________ License Plate Number _________________
  • Insurance Information 
    • Company: __________________________ Date of expiration: _______________ 
    • Policy # ________________________________________
  • Waiver/Certification: In consideration of me 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 this vehicle that covers my liability and physical damage as required in my state of residence. 

I, the undersigned, release and hold harmless the MCCTA host officers, directors, 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.

Printed name of Owner/ entrant: _____________________________

Signature Owner/entrant: ____________________________ Date ______________