WWCC 10 Mile Time Trial (2019) #9

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Team name   First name   Last name   Email address   Date of birth DD 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31    MM 01 02 03 04 05 06 07 08 09 10 11 12       YYYY 2019 2018 2017 2016 2015 2014 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 1941 1940 1939 1938 1937 1936 1935 1934 1933 1932 1931 1930 1929 1928 1927 1926 1925 1924 1923 1922 1921 1920    Gender -- Male Female   Club name Choose one Exeter Wheelers CC Minehead CC RFRC RNRMCA Somerset RC Tri Somerset Road Club Synergy Massage & RT Wellington Wheelers Other     Phone #   Emergency contact name   Emergency phone #   Category Choose one Espoir Junior Juvenile Senior Super Veteran Veteran   Event entry fee 5.20 GBP

Please review the waiver provided by the event organizer and click the check box below to accept it. Print waiver The event is being run for and on behalf of Cycling Time Trials under their Rules and Regulations as shown in the current Handbook. I am conversant with such Rules and Regulations and undertake to abide by them and to participate in the Drug Testing Programme whenever required to do so. I am at present not under suspension by Cycling Time Trials or any organisation with which Cycling Time Trials has an agreement. I accept the decision of the promoter in all the matters concerning the event and my participation in it subject to such rights of appeal or review as may be provided for in the Rules and Regulations of Cycling Time Trials. I understand that the event is held wholly or in part on public or private property or the public highway. That I participate therein at my own risk and that no liability whatsoever shall attach to the property owner or anyone devolving an interest in the property there under, the promoting club, its officers, officials, helpers in the conduct of the event, Cycling Time Trials or any club affiliated thereto or any member of such club or any injury loss or damage suffered by me in or by reason of the event howsoever such may be caused and whether by negligence or otherwise. I confirm that I will observe the particular rules and conditions of this event of which I have been informed. I accept the terms of the waiver Name of parent or guardian who approves this activity