| To the Secretary: Please enter me for the: | Date |
Distance |
Actual Time or Distance |
Date |
Fastest Rider, Time & Distance |
|
| Fastest performance during current & past 3 seasons | ||||
| Last 2 performances | ||||
| Last 2 performances | ||||
| Fastest performance at this distance since January 1 this year. |
In the interests of your own safety, Birkenhead North End CC strongly recommends that you wear a hard shell helmet that meets an internationally-accepted safety standard.
I understand and agree that the event is held on the public highway and that I participate therein at my own risk and that no liability whatever shall be attached to the promoter, promoting club or any officials of the event, CTT or any affiliated club thereto for any damage suffered by me in or by reason of the event however such may be caused and whether by negligence or otherwise.
| BLOCK LETTERS: Surname | Initials |
| Date of birth if under 18 years of age on the day of the event: | / / |
| Signature: | Date |
I hereby declare that the particulars on this form are complete and correct. I accept the conditions appertaining to the event as set out in the entry form published by the Promoter. I understand that the event will be held under the rules and regulations of CTT as shown in the current handbook and confirm that I am conversant with such rules and regulations and undertake to abide by them and to participate in CTT drug testing programme whenever required to do so. I further declare that I am not at present under suspension by CTT or any organisations with which CTT have an agreement or (if so) such suspension will have expired by the date of the event. I agree to accept the decision of the promoters in all matters concerning the event and my participation in it, subject only to the rights of appeal or review as may be provided for in the rules and regulations of CTT.
The completed form should be sent to: Peter Byrne, 4 Menlo Avenue, Irby, Wirral, CH61 3UR