RACE ENTRY FORM

EVENT NAME DAY & DATE 2002
 First Name: DOB:
  Surname: Sex: Male: Female:
No. Address  
Address  
Town:  
 County  
 Post Code: Tel No:
 E-Mail:
 Club/Sponsor:

Please Enter one category only

Category Ages
Entry Fee
Tick
Fun 12+
£00
Hardtail 12+
£00
Elite 19+
£00
Senior 19-29
£00
Master 30-39
£00
Veteran 40+
£00
Junior 17-18
£00
Youth 14-16
£00
Juvenile 12-14
£00
On The Day Entry
+ £2
  
Total Entry Fee

I hereby apply to participate in the event(s) indicated above.  I or my parent/guardian accept and agree that neither the organizers, nor their agents, officials, the landowners, sponsors or fellow competitors shall be liable in any way, or in any circumstances for any damage or injury that I may suffer during, in connection with, or as a result of taking part in this event. I will abide by the rules of the series.  I agree that I participate in this event entirely at my own risk and that I must ride in a manner which is safe for myself and all others.  I also declare that the cycle I will ride in the event is in good working order and properly maintained.
ENTRY INVALID WITHOUT SIGNED DECLARATION
Signed:
Parent/Guardian (if under 18):
Date:
 

Please make cheques payable to: 'NAME' (no post dated cheques) Please print off this entry form and send to:

Name
Address
Address
Town.,
Post Code

Tel: day 0000 000000 - Mobile 0000 000000

No entries accepted without payment. Please supply name address of cheque holder if different from the competitor. Returned cheques will have an administration levy,

Have you checked you completed the form correctly and SIGNED YOU CHEQUE

Racing numbers are issued on the day (£2 deposit returnable)


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