Ring of Beara Cycle Kenmare Saturday 23rd May 2015

Transcription

Ring of Beara Cycle Kenmare Saturday 23rd May 2015
Ring of Beara Cycle Kenmare
Saturday 23rd May 2015
Postal Application Form
First Name
Surname
Club Name
Email Address
Date of Birth
Address
Town
County
Gender:
Country
Male
Mobile
Female
Please select race distance:
100km
140km
Date
100km & 140km Routes
Buddy Entry (2 x Entries)
Dec 1st - 31st
€40
€75
Jan 1st - March 1st
€45
€85
March 2nd - May 1st
€50
€90
May 2nd - May 20th
€55
€100
May 22nd & 23rd - Cash Only
€60
---
Entries will not be processed unless the following
disclaimer is signed by the participant
It is recommended that any potential participant not
currently involved in physical sporting activity, should
undertake a medical examination before taking part
in the race. I understand that participating in this
event is physically demanding, and that I should not
enter and participate unless I am medically able and
properly trained. I understand that participating in this
event is potentially hazardous, and that I should not
enter and participate unless I am medically able and
properly trained.
In consideration of the acceptance of this entry, I
assume full and complete responsibility for any injury
or accident which may occur while I am traveling to
or from the event, during the event, or while I am on
the premises of the event. I also am aware of and
assume all risks associated with participating in this
event, including but not limited to falls, contact with
other participants, effect of weather, traffic, and
conditions of the road.
I, for myself and my heirs and executors, hereby
waive, release and forever discharge the event
organizers, sponsors, promoters and each of their
agents, representatives, successors and assigns, and
all other persons associated with the event, for all my
liabilities, claims, actions, or damages that I may have
against them arising out of or in any way connected
with my participation in this event. I understand that
this waiver includes any claims, whether caused by
negligence, the action or inaction of any of the above
parties, or otherwise. I understand that the entry fee
is nonrefundable and non-transferable.
By submitting this application I agree to be bound by
all the rules of the event.
I understand that I enter the Ring of Beara Cycle
Kenmare at my own risk and that neither Kerry
County Council, Cork County Council, Elite Event
Management, Department of the Environment and
local government or any of its employees, servants or
agents, any sponsors, associate sponsors, or patrons,
will be held responsible for any accident suffered or
injury sustained by myself from any cause whatsoever,
or for any property lost, damaged, mislaid or stolen,
on the course, from my person or at the changing
areas or at any place. I agree to abide by all lawful
instructions issued to me by An Garda Siochana or
the stewards on the Course on the day.
I have read, understand and agree to all of the above.
Signature: ..................................................
Date: .......................................................
www.ringofbearacyclekenmare.com
Payment Procedure
Please return all completed
registration forms and appropriate
cheque or postal order to: Elite
Event Management, Dunloe Cottage,
Dunloe, Upper Beaufort, Killarney,
Co. Kerry
All cheques made payable to
Elite Event Management
When we receive your payment in
full we send you a receipt of
payment. Please visit our website
for all pre-registration details.
Contact
For full race details or any queries
please contact [email protected]
or call Oliver Kirwan 087-6024621
or visit our website
www.ringofbearacyclekenmare.com

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