Rider Details | www.greatwestonride.com

Please submit the form below to complete your entry & receive your entry confirmation email (one form needed PER RIDER):

NB please ensure that you have paid for your entry via the Online Entry page BEFORE completing & submitting the form below.

CONDITIONS OF ENTRY

Rider Details Form

First Name

Surname

Date of Birth

Phone No.

Address

Town/City

Postcode

Emergency Contact Name

Emergency Contact No.

DECLARATION: I DECLARE THAT THE INFORMATION ON THIS FORM IS COMPLETE AND CORRECT. I UNDERSTAND AND AGREE THAT I PARTICIPATE IN THIS EVENT ENTIRELY AT MY OWN RISK; THAT I MUST RELY ON MY OWN ABILITY IN DEALING WITH ALL RISKS; AND THAT I MUST RIDE IN A MANNER THAT IS SAFE TO MYSELF AND TO OTHERS. I AM AWARE THAT WHEN RIDING ON A PUBLIC HIGHWAY THE FUNCTION OF MARSHALS IS ONLY TO INDICATE DIRECTION AND THAT I MUST DECIDE IF THE MOVEMENT IS SAFE. I AGREE THAT NO LIABILITY WHATSOEVER SHALL ATTACH TO THE ORGANISER/PROMOTER, PROMOTING ORGANISATION, EVENT SPONSOR, BRITISH CYCLING, OR ANY EVENT OFFICIAL OR MEMBER OF BRITISH CYCLING OR MEMBER OF THE PROMOTING ORGANISATION IN RESPECT OF ANY INJURY, LOSS OR DAMAGE SUFFERED BY ME IN OR BY REASON OF THE EVENT, HOWEVER CAUSED.

In submitting this form I hereby acknowledge that I have read and agree to abide by the above declaration, and I accept the Ride's 'Conditions of Entry'.

Thank you for submitting your details!

PLEASE NOTE: If you experience any problems with the Rider Details online form or if the online form above fails to send please click on the 'Backup Entry Form' below; fill in your details & save the form; and then email the completed form to us at mail@greatwestonride.com. We will then input the details for you manually and this will trigger your entry confirmation email.

BACKUP ENTRY FORM

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