Morecambe Midsummer Madness Entry Form

Please complete all the details on this form. Clicking submit will take to you to secure Paypal entry. If you do not have a Paypal account you can still use a debit or credit card to make a payment.

Morecambe Midsummer Midnight Madness - Entry Form (please complete all boxes)

First Name *

Please enter your first name

Last Name *

Please enter your last name

Address 1

Address 2

Town

Post Code

Email *

Mobile or Number *

Cycling UK Membership Number (if you have one)

Name of emergency contact *

Their mobile or other contact number *

Relationship to Rider

Disclaimer

Disclaimer for entrants (to be signed at the start of the ride)
I agree that I understand and will abide by the terms and conditions required by Cycling UK for the safe participation in this activity and to act responsibly and adhere to the rules of the road and countryside. It is my responsibility to ensure that all manoeuvres are carried out safely. I hereby maintain that I am fit and healthy enough to participate in the activity described above and my cycle is in a safe, legal and rideable condition. I also accept that Cycling UK cannot be held responsible for any personal injury, accident, loss, damage or public liability during the event. I am over 18 years of age.

Confirm you accept the disclaimer *

I agree to the entry conditions

Amount of Payment

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West Yorkshire CTC

Audax and other events in West Yorkshire

Audax and other events in West Yorkshire

Morecambe Midsummer Madness Entry Form

Please complete all the details on this form. Clicking submit will take to you to secure Paypal entry. If you do not have a Paypal account you can still use a debit or credit card to make a payment.