INSTRUCTIONS: Please complete this form fully and accurately and return it to the office of the Department of Veterans Affairs (VA) shown below. Enclose. Have the application notarized on page 6?â–¡. Fill in the Billing Contact information on page 7? By signing below, you have read and agree to the terms and conditions of the Release and Waiver of Liability,. Prior to entry to the Race Meet grounds, all entrants must fill out this health self-assessment questionnaire.