WWCC West Buckland Hill Climb 2019

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Team name   First name   Last name   Email address   Age on event date 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100 Gender -- Male Female Female/Male   Emergency contact name   Emergency phone #   Category Choose one Junior Juvenile Senior Veteran   Event entry fee 5.00 GBP

Please review the waiver provided by the event organizer and click the check box below to accept it. Print waiver I understand that the event is held wholly on the public highway. That I participate therein at my own risk and that no liability whatsoever shall attach to 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 CONFIRM THAT I HAVE READ ALL THE SAFETY INSTRUCTIONS CONTAINED IN THE START SHEET ON THE WELLINGTON WHEELERS CC WEBSITE AND DISPLAYED AT THE SIGNING-ON POINT. I ALSO UNDERSTAND THAT WELLINGTON WHEELERS CYCLING CLUB RECOMMENDS THAT I WEAR A HARD SHELL HELMET THAT MEETS AN INTERNATIONALLY ACCEPTED SAFETY STANDARD. I accept the terms of the waiver Complete consent form https://www.wellingtonwheelers.co.uk/parental-consent