A U K - To enter an event please use your Web browser to print this page - A U K
then complete and sign the form below and send, with payment and 2 SAEs, to the Organiser.

Name of Event ...Beacon Roads CC Cotswold Expedition / Cotswold Journey / Cotswold Outing
From ...Cheswick Green
Dist ...201 / 155 / 101 Kms (please circle as appropriate)
Date ...Sunday 15th June, 2003
Fee £...3:50 (+ temporary membership fee of £1:00 if required - see below)
AUK Membership no. .......................... (enter your number in full, or see TEMPORARY INSURANCE FORM below)
Date of birth if under 18........................... (the PARENTAL CONSENT section must be completed)
Forenames ...
Surname ...
Address ...
P’code ...
Tel ...
e-mail ...
Club (if any) ...
CTC DA (if any) ...
ENTRY: Entrants should note that this event is held on the public highway and, whilst the aim is to use quiet roads, it is impossible to avoid trafficked A and B roads. Routes may cover high and exposed ground and be a severe test of stamina and cycle control. Entrants should be aware of the usual hazards such as junctions and other traffic and occasional hazards such as roadworks and poor road surfaces. Entrants should ride safely, according to the rules of the road and within their own capabilities. Entrants should familiarise themselves with the route and ensure that they are fit and competent to undertake this event. Entrants agree to abide fully with the AUK Regulations of the event, in particular, responsibility for the roadworthiness of the machine is that of the entrant. Entrants must consider themselves as being on a private excursion and rely on their own arrangements in the event of failure to complete the course.

I, the undersigned, have read and understand the above.
INSURANCE COVER : I am an AUK Member, or otherwise I have third part insurance via my relevant CTC or Individual BCF Membership. My CTC/BCF membership number is: ...
otherwise I have applied below for temporary AUK Membership:

Signed ...
Date ...
Please give the organiser as much notice as possible if you are unable to ride the event

PARENTAL CONSENT
This is required for entrants under 18 years of age. Parents should read and take note of the information above. They should also be aware that there are no leaders.
I am the parent/guardian of the entrant, have read and understood the entry information, and give my consent to this entry:

Signed (Parent/Guardian) ...
Date ...

APPLICATION FOR TEMPORARY THIRD PARTY INSURANCE COVER
I wish to apply for temporary INSURANCE COVER for the event above. I understand that this entitles me to THIRD PARTY INSURANCE COVER under the AUK Public Liability Policy for the period of the ride. I enclose £1 temporary insurance fee.

Name (Please print clearly) ...
Signed ...
Date ...