SITEKI BICYCLE RACE 1 OCTOBER 2011

Race Schedule

Distances
10 Kms
20 Kms
35 Kms
65 Kms
ENTRY FORM
PARENT OR GUARDIAN TO SIGN/AGREE IF CYLCIST IS UNDER 18 YEARS OF AGE.
Full Name :
Date of Birth:
Sex: Male:     Female
DISTANCE:


Please Note The Following Restrictions:

10KM – CHICKEN RUN UP TO 7 YRS ONLY

20KM – ANKLE BITTERS 8 - 10 YRS ONLY
              BRATZ 11 -13 YRS ONLY

10Kms: 20Kms: 35Kms: 65Kms:

Men Women
Chicken Run ( 1-7) Chicken Run (1-7)
Ankle Bitters (8-10) Ankle Bitters (8-10)
Bratz (11-13) Bratz (11-13)
Youth (14-16) Youth (14-16)
Junior (17-18) Junior (17-18)
Senior (18-29) Senior (18-29)
Sub Vet (30-39) Sub Vet (30-39)
Vets (40-49) Vets (40-49)
Maters (50-59) Masters (50-59)
Masters (60+) Masters (60+)




RACE NUMBER:
CONTACT NO.:
DOCTOR AND NUMBER:
BLOOD GROUP:
EMAIL:
ALLERGIES:
T-SHIRT SIZE: XS   S   M   L   XL   XXL
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.

REMEMBER NO HELMET - NO RIDE

I Agree I Do Not Agree


INFORMATION

Tel/fax: (+268) 2404-9609
Email: zoe@adventuresport.co.sz