REGISTRATION FORM FOR 200 km BRM ON 12.08.2012
TERMS AND CONDITIONS FOR PARTICIPATING IN A BREVET RANDONNEURS MONDIAUX
1. I agree to abide by the Ride Rules of Mumbai Randonneurs, Audax India Randonneurs, and the Ride Rules of AUDAX CLUB PARISIEN http://www.audax-club-parisien.com/EN/index.php?showpage=322
2. I agree to comply with the traffic and road laws and regulations of Maharashtra in which I am travelling as they affect the use of a bicycle.
3. I fully understand and agree that I am entering this event entirely at my own risk and accept without exception full and complete liability for all and any risks and will not hold responsible nor make claims against Audax India Randonneurs, any of the participants or organiser, its committee members, agents or servants for any loss, damage or injury however caused in relation to my participation in this event.
4. I understand that I am required to wear a helmet at all times during the event.
5. I understand that I am required to comply with the lighting requirements set out in the Ride Rules. These requirements apply for a ride on which any part of the maximum time is at night (i.e. between sunset and sunrise) and include:
a) Having an effective front and rear light and a rear red reflector attached to the bicycle (and spare front and rear lights);
b) Having those lights switched on at all times of darkness or low visibility; and
c) Wearing a reflective vest or bandolier at all times of darkness or low visibility.
6. I understand that all decisions of qualifying or disqualifying are final and cannot be appealed against.
7. I have not been disqualified from any BRM till date for committing any fraud, cheating, or deliberate violation of ACP Rules!
I have read and understood the Rules of BREVET RANDONNEURS MONDIAUX, AUDAX CLUB PARISIEN *
Required
I understand that I will not be allowed to ride without front and rear lights and reflective vest . *
Required
I understand that I will not be allowed to ride without a helmet. *
Required
I understand that I will not be allowed to ride without my Rider Number displayed on the front and rear of the cycle. *
Required
I understand that I need to carry a credit/debit card to be used at unmanned control points. *
[There will be an inspection at the start and the card number will be noted.]
Required
I ACCEPT THE TERMS AND CONDITIONS *
Required
LAST NAME *
Your answer
FIRST NAME *
Your answer
RIDER NUMBER (if you been assigned your Permanent Rider Number at an earlier BRM)
[Rider Number is to be displayed on the front and back of your bicycle.]
Your answer
SEX *
Address *
Your answer
Email Address *
Your answer
Phone No. *
Your answer
Emergency Phone No. *
Your answer
Date of Birth *
dd.mm.year
Your answer
Proof of Identity *
I.D. that you will carry with you
Registering for 200 km BRM (12 Aug 2012) *
Required
I UNDERSTAND THAT ON FILLING THIS FORM I AM REQUIRED TO TO PAY REGISTRATION FEES OF Rs. 350/- *
REGARDLESS OF NON-PARTICIPATION FOR ANY REASON
Required
I agree to pay the registration fees at the start of the Brevet
[I understand that registration fees are non-refundable under any circumstances. Non-payment of fees will result in not being able to participate in future BRMs until previous dues are paid!]
Parent Name (for participants below 18 yrs only)
[This is necessary for riders less than 18 years of age. Riders 16 years and under must be accompanied by a responsible adult.] I have read and understood the information contained on this entry form. As the parent/guardian I consent to my child taking part in this ride organised by Mumbai Randonneurs.
Your answer
Parental Consent (for participants below 18 yrs only)
[This is necessary for riders of less than 18 years of age. A letter of consent must be submitted at the time of paying the fees.]
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