1. I am a financial member of the Maserati Club of Victoria ACN 148 275 543 (Club).
2. I am the owner of the Vehicle described below.
3. I am [the holder of/l am applying for] a Club Permit as defined under the Road Safety (Vehicles) Regulations 2009 (Regulations).
4. I warrant that the Vehicle is eligible to be issued with a Club Permit, is safe for on-road use, and meets the requirements for holding a Club Permit that are prescribed by VicRoads or under the Regulations, including:
a. that the Vehicle is:
• a veteran vehicle a vehicle manufactured before 1 January 1919); or
• a vintage vehicle (a vehicle manufactured after 31 December 1918 and before 1 January 1931); or
• a classic or historic vehicle (a vehicle manufactured after 31 December 1930 and more than 25 years old before the date of application for a club permit); or
• a replica of any of the above vehicles,
within the meaning of regulation 152 of the Regulations; and
b. that the Vehicle meets the vehicle standards as declared on the VicRoads Vehicle Eligibility and Standards declaration provided with the Club Permit application.
5. I warrant that I personally meet the eligibility criteria to be a member of the Club and to hold a Club Permit under the Regulations, VicRoads requirements and the Club rules.
6. I warrant that I will notify both VicRoads and the Club as soon as possible should there be any material change to the Vehicle or my personal circumstances that may affect the accuracy of my warranties given in paragraphs 4 and 5.
7. To the fullest extent permitted by law, I indemnify and keep indemnified the Club, its employees and agents against any claims, liabilities, costs, losses or expenses that may occur in connection with:
a. my use of the Vehicle;
b. my failure to comply with requirements for holding a Club Permit; and
c. my failure to abide by any warranty given in this document;
d. any false or inaccurate statement in this document; and
e. any breach by me of the Regulations or requirements of VicRoads or Club rules.