BURGESS
HILL BIKE RIDE INTERNET BOOKING FORM
Please
send the completed form with entrance fee cheque (adults £6, children
under 17 £3) payable to:
Burgess Hill Bike Ride to 64 Cuckfield Road, Hurstpierpoint, BN6 9SB
to arrive as soon as possible. Receipts will be issued if an S.A.E. is
included, otherwise entrants’ packs will be sent out in May.
I have read and
agreed to the above Conditions. I have read the section “Your
Health” and have obtained my doctor’s approval if necessary. I have no
objections to the details below being stored on a database for the exclusive
purposes of this event and for future Burgess Hill Bike Rides. I am 12 years old
or over.
Name Signature Age (if 12 - 17)
Address
Post
Code
Email address
Telephone
PLEASE
INDICATE T SHIRT SIZE (delete as appropriate):
LARGE /
EXTRA LARGE
If you are aged
12 - 17 please ask your accompanying adult to complete the following:
Name
Address
Telephone
and
ask your parent/guardian to sign below in agreement to the Conditions section on
your behalf:
Signature
Name
Date
WIN A MOUNTAIN BIKE!
Event
organisers: Burgess Hill,
Haywards Heath and District Round Table (Registered Charity No.
1058108)
and Burgess Hill District Lions Club (Registered Charity No. 1010082)
Return to section "Your Health"
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