Entry Form for Events held under AUDAX UK Regulations
To Gerry Boswell : this form has been downloaded from the NYDA website (AUK Form modified for NYDA web-site),
and is almost identical to the one published in the hardcopy AUK Calendar 2007
Name of Event:
Gerry's Autumn Brevet From:
Wigginton Recreation Hall SE602586 Dist:
101km Date:
Sun, 12th Oct 2008 Fee £2.00 or £4.00 (with TEMPORARY MEMBERSHIP see below)
AUK Membership No:
(letter & number, or see TEMPORARY MEMBERSHIP below)
Date of birth:
if under 18 years: (see PARENTAL CONSENT below)
Forename:
Surname:
Address:
Tel:
email:
DA/Club:
This event is run under Audax UK regulations. It is not a race or trial of speed. You are expected to follow the rules of the road and show consideration to other road users. It is your responsibility to familiarise yourself with Audax UK regulations, guidance, and advice. (Members receive these via AUK publications. Others may find them on the AUK website at
www.audax.uk.net, or may request printed copies from the organiser of the event.)
Note:-
» The route is on open public roads. » Some routes may be arduous.
» The route is not waymarked or marshalled. » You should prepare by studying the route.
» The organiser provides no rescue service. » You are responsible for your safety/conduct.
TEMPORARY MEMBERSHIP If you are not a member of AUK, we need to know that you are insured. Some CTC or BC memberships include the requisite cover, so if this applies:
Give your CTC or BC membership no:
Or you must pay the temporary AUK membership fee, which provides 3rd party cover during the event.
PARENTAL CONSENT (required for entrants under 18 years of age) Parents should note the information on this form and be aware that this is an individual ride without leaders.
I am the Parent/Guardian of the Entrant and give my consent to this Entry:
Signed (Parent/Guardian): ______________________________________ Date:
Name (Parent/Guardian, please print):
I acknowledge that during the event I am on a private excursion on the public highway and that I am responsible for my own conduct. I agree to abide by Audax UK Regulations for this ride. I have relevant insurance cover as above or I enclose the £2.00 temporary membership fee. Signed (Entrant): ______________________________________ Date:
Rider's next of kin (Name & Tel.):
Check that you have signed wherever required.
Please let the organiser know if you cannot start. The organiser may refuse, or charge more for, late entries on the day. Entry fees are not refundable.
Send to the organiser of the event:
1. completed form 2. cheque payable to organiser (not AUK) 3. two C5 stamped addressed envelopesRevised Oct 2006