Entries

Permit Number: ACU 55043

Entrant

Forename:*
Surname:*
Date of Birth: **
Address: *
Town: *
County: *
Other:
Postcode: *
Phone Number: *
E-mail Address: *

Entry Fee

Individual Entry Fee £30.00

Passenger

I wish to carry a passenger? (£9.00)
Forename:*
Surname:*
Date of Birth: **
Copy Rider's Address?
Address: *
Town: *
County: *
Other:
Postcode: *
Phone Number: *
E-mail Address: *

Details

Machine Make: *
Machine Capacity: cc*
Type:
Year: *
Club Name (If any):
Road Traffic Act Insurance: I acknowledge that I comply with the necessary requirements and I wish to sign on for RTA Insurance for the
duration of this event for no additional cost(See clause 7 of the regulations)
Rider
Passenger RTA
Total £

* Required Field
** Required to determine Oldest Rider/Youngest Rider Awards
*** Required if a passenger is to be carried

ACU - Bikesport GB