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2007
Siteki Bicycle Race - Saturday 18th August

>> Siteki race directions and accommodation <<

PARENT OF GUARDIAN TO SIGN/AGREE IF CYLCIST IS UNDER 18 YEARS OF AGE.
Full Name :
Date of Birth:
DISTANCE: 20Kms:     30Kms:     60Kms:  
CONTACT NO.:
BLOOD GROUP:
EMAIL:
ALLERGIES:
DOCTOR'S NAME
AND PHONE NUMBER:
T-SHIRT SIZE: S   M   L   XL   XXL    

BANKING DETAILS FOR PAYMENTS
ADVENTURE SPORT - FIRST NATIONAL BANK
ACCOUNT NUMBER - 62029675686
BRANCH - 280164
FAX PROOF OF PAYMENT TO +268-4046550 OR E-MAIL proof to zoe@adventuresport.co.sz


Indemnity / waiver

I undertake to participate entirely at my own risk. I agree that I shall have no claim whatsoever against the organizers, officials, marshalls, helpers, sponsors or any local authority or employee of aforementioned parties, for any loss, damage or injuries whatsoever which I may suffer as a result of my participation in this event, including my arrival and departure there from, and any ceremonies as a result of this function, and I accept responsibility for my own health insurance. In the event of my signing this form as a guardian of a minor, I am bound by the above waiver including to the extent to thich he/she is not capable of waiving his/her rights stipulated above.

I Agree I Do Not Agree

REMEMBER NO HELMET - NO RIDE

 


INFORMATION

Tel/fax: (09268) 404-9609
Email: zoe@adventuresport.co.sz