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Advancing palliative and respite care for young adults in the North West and North Wales

Limite d so ap places, ply to day!

Sunday 4th Sept. 2016 British Cycling approved event Choice of two scenic routes 70 mile long route and 40 mile short route Chip registration and timing Start and finish at Cheshire Sports Club, Upton, Chester Waymarked route Midway feed station Gift for every rider

Supported by;

How to Enter www.britishcycling.org.uk/events/details/140495/Cheshire-Ride-for-Life-NoW

Or at bit.ly/1RRCkua Or by post (see flyer or overleaf) Entry fee of £20. All profits go to Life NoW, the charity aiming to provide hospice care for young adults in the North-West and North Wales. Find out more at www.lifenow.org.uk

BRITISH CYCLING NON-COMPETITIVE EVENT ENTRY FORM (under British Cycling Regulations) To the Organiser:

J. Lewis, 33, Keristal Ave., CHESTER. CH3 5XA Event name:

Cheshire Ride for Life NoW

Event date:

Title:

Date of Birth:

First name:

Surname:

4/9/2016

Ride distance:

70 /40 mi

I enclose entry fee of (£):

20.00

Address:

Town:

County:

Postcode:

Telephone no:

Mobile no:

Email:

Emergency contact name:

Emergency contact no:

Club/Team name (if applicable):

Medical Conditions (if applicable): "I agree to abide by the British Cycling Regulations for non-competitive cycling events, and 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 hazards, and that I must ride in a manner which is safe to myself and 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 whether the movement is safe. I agree that no liability whatsoever shall attach to the promoter, promoting club/Organisation, event sponsor, British Cycling or any event official or member of British Cycling or member of the promoting club/organisation in respect of any injury, loss or damage suffered by me in or by reason of the event however caused. I will participate in cycling events in a loyal and sporting manner. I will submit to disciplinary measures taken against me and will take any appeals and litigation to the authorities provided for in the Regulations. Subject to that reservation, I shall submit to any dispute that may arise exclusively to the courts. I have read and agree to abide by the above declarations”.

Signed:

Date:

ENTRIES WITHOUT CORRECT FEE OR DETAILS WILL NOT BE ACCEPTED

Cheques payable to “Life NoW” (by 29.8.16 at latest)