ENTRY FORM – INISHOWEN 100/60
| Surname: | |
| Forename: | |
| Gender: | Male / Female |
| D.O.B. | |
| Address: | |
| Address: | |
| Address: | |
| Address: | |
| Postcode: | |
| Daytime Tel No: | |
| Evening Tel No: | |
| Email Address: | |
| Average Training Speed: | MPH / KMPH |
| Course Selection | 100 Miles / 60 Miles |
I agree to abide by the Rules of the road and the event.
I understand that I enter the event at my own risk and that no person(s) or organisation(s) will be held responsible for any accident, injury or loss to me, prior to, during, or after the event.
I understand that the organisers reserve the right to alter arrangements and conditions should circumstances require.
To allow the event to finish by the time agree with the Police authorities and Templemore Sports Complex, I agree to make use of the sweeper van if I am requested by an event marshal.
Signature: _______________ Date: ____________
Entry forms should be returned by the 30th July 2011 to Foyle Cycling Club, 60 Templegrove, L’Derry, BT48 0NQ.
Please send cheques, do not send cash or postal orders. Write your name and address on the back of your cheque and make the cheque payable to Foyle Cycle Club.
If entries are received after the 30th July the entry fee is £30 (35 euro) we are unable to guarantee finishing certificates, so please post in good time.
