REGISTRATION FORM FOR 400 km BRM (Kolhapur Kurry)Pune - ON 07.01.2012
TERMS AND CONDITIONS FOR PARTICIPATING IN A BREVET RANDONNEURS MONDIAUX
1.  I agree to abide by the Ride Rules of Randonneurs India, 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 Randonneurs India, 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!
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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 rider no displayed on the front and rear of the cycle. *
Required
I understand that i need to carry a credit or debit card to use for the unmanned control point on finish of BRM. *
there will be an inspection at start and card number will be noted.
Required
I ACCEPT THE TERMS AND CONDITIONS *
Required
FIRST NAME *
LAST NAME *
RIDER NUMBER (if you have done a BRM and been assigned your permanent rider no.)
it is to be displayed on your cycle in front and back
SEX *
Address *
Email Address *
Phone No. *
Emergency Phone No. *
Date of Birth *
dd.mm.year
Proof of Identity *
I.D. that you will carry with you
Registering for 400 km BRM *
07.01.2012
Required
I UNDERSTAND THAT ON FILLING THIS FORM I AM REQUIRED TO TO PAY REGISTRATION FEES OF Rs. 300/- *
REGARDLESS OF NON-PARTICIPATION FOR ANY REASON
Required
I agree to deposit the registration fees at one of the bike store: 1) Orbea RIDE2026 shop, opp Chroma,  Aundh, 2) Track and Trail, Karve Road, 3) Life Cycle Mall, Tilak Road, 4) Rider Owned Bikes, Lane 7, Koregaon Park, Pune
i understand that the fees must be paid at least 3 days before the respective BRM. I understand that it is non-refundable under any circumstance. 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)
is necessary for riders of less than 18 years of age. Riders 16 years and under must be accompanied by a responsible adultI 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 Pune Randonneurs.
Parental Consent (for participants below 18 yrs only)
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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