DECLARATION
Subject:
Conditions of Use for a Motorised Mobility Scooter/Power Chair/Wheelchair on
a Roadway (hereafter refer to as Scooter)
I / We (please print name/s) ____________________________________________________
Of
( Resort Address) _________________________________________________________
(please
print address)
in the TRNC
And
HOME ADDRESS _______________________________________________________
__________________________________________________________________________
do solemnly and sincerely declare that-
The
Scooter will be used solely by the applicant for whose transport such
a Scooter is necessary and who possesses a current medical certificate
certifying to this effect and;
the Scooter will be driven on footways
and. if the footway is not suitable, as close as possible to
the left hand boundary of a carriageway and until the earliest opportunity
arises to make use of the footway;
When crossing a carriageway I
will observe the traffic and choosing a safe time to cross, ensuring that no traffic
is approaching, use the most direct route available and always be responsible
for my own safety;
I
will travel at a speed not in excess of 4 miles per hour and while
on such footways;
I will exercise due care and attention in regard to the safety of others.
INDEMNITY CLAUSE
1. The Hirer shall indemnify the Owner, the Owner's employees and agents from all loss, damage,
injury, actions or claims arising either directly or indirectly from use, maintenance, transport or
operation of the hired equipment or otherwise.
2.
The Owner is not liable to the Hirer or Hirer's servants or agents
for any loss, damage, injury,
actions or claims arising either directly or indirectly from any representations, warranties, terms or
conditions expressed or implied for the use, maintenance, transport or operation of the hired
equipment or otherwise, whether resulting from the negligence of the Owner, the Owner's
employees, agents or otherwise.
Dated this __________________day of________________2007
Signature/s
of Declarants.____________________________________________________
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