14th June 2021 Club Time Trial Sign-on
I understand that the event will be held under the Rules and Regulations of Cycling Time Trials as shown in the current Handbook and I confirm that I am conversant with such Rules and Regulations and undertake to abide by them and to participate in the Drug Testing Programme whenever required to do so.

I further declare that I am at present not under suspension by Cycling Time Trials or any organisation with which Cycling Time Trials has an agreement or (if so) such suspension will have expired by the date of the event. I agree to accept the decision of the promoter in all the matters concerning the event and my participation in it subject to such rights of appeal or review as may be provided for in the Rules and Regulations of Cycling Time Trials. I understand that the event is held wholly or in part on public or private property or the public highway and that I participate therein entirely at my own risk and that no liability whatever shall attach to the promoter, promoting club or any officials of the event, Cycling Time Trials or any club affiliated thereto or any member of such club for any injury loss or damage suffered by me in or by reason of the event however caused.

As an entrant to this event your information may be shared on the event or promoting club website, social media pages or in emails sent by or on behalf of the promoting club. This data will only be shared in relation to your participation in the event, e.g. the list of entrants, results or event reports. This data will be limited to your name, gender, age or age category, the name of the affiliated club or team of which you are a member and your finishing time and/or position.
Email *
Title *
Name (Firstname, Lastname) *
Address, including postcode *
Mobile Telephone Number *
Emergency Telephone Contact *
Emergency Telephone Number *
Club *
2nd Tandem Rider Name (they must also complete this form)
Estimated Completion Time *
Age *
Clear selection
Full Name (this will be taken as signature for sign-on and acceptance of regulations) *
A copy of your responses will be emailed to the address you provided.
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