CTC Ride Form - DOC by 04t6jy

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									                                                                                                                                                       ENTRY FORM FOR EVENTS
                        PARENTAL CONSENT FORM
                                                                                                          EVENT:                                          Romsey Round 75 miles
                                                                                                                                                                   th
                                                                                                          DATE:                                           Sunday 25 March 2012
Notes for Parents & Guardians                                                                             DISTANCE:                                       75 miles
                                                                                               General Information:
All participants under the age of 18 must have a signed CTC parental consent form. The
only exemption is where a young person having reached the age of 16 can prove that             Start: 9 am from Broadwater car park Romsey (SU 354 211) (free on Sunday)
they are no longer living with their parents or guardian and are living as an independent      Finish: Bear & Ragged Staff, Michelmersh (SU 335 258) – 3 ½ miles from start
adult. This needs to be proven by the supply of evidence such as a rent book or utility bill
with the person’s current address in their name or a National Students Union membership        Entry Fee: £3.00:
card.                                                                                          Entry can be in advance or on the day.
The minimum age for unaccompanied children on this event is 13. There is no lower age
                                                                                               To enter in advance: Complete entry form and post to organiser with cheque
limit if accompanied by a responsible adult acting in loco parentis, but a signed parental     payable to Sue Coles and s.a.e. for return of route sheet*.
consent form is still needed. Children aged 13 to 17 may participate unaccompanied if          To enter on day: Complete entry form, download route sheet* & bring both to start.
they have parental permission and the parental consent form is signed.
                                                                                               *Route Sheet and gpx file can be downloaded from www.southhampshirectc.org.uk
Parents or guardians must be aware:
                                                                                               or obtained from local CTC contacts. The route is on OS 184, 185 and 174.
     of the demands of this cycling event and that they alone make the decision
         about the ability of their child to complete the ride.
     that the child may cycle with other adults and / or with children, but that there is     Minimum time limit: 5 hrs Maximum time limit: 7 ½ hrs
         also a likelihood of the child cycling on their own (for example in treasure hunt     Food at finish: The Bear and Ragged Staff serves food all day. .
         events).                                                                              Organiser: Sue Coles, 7 Ruffield Close, Winchester, Hampshire, SO225JL 01962
     that while CTC extends a welcome to cyclists of all ages and abilities, no               864479      events@southhampshirectc.org.uk
         special provision for children is provided on this event.                             Additional notes: Public roads and rights of way will not be closed and therefore entrants must
Arrangements to get to and from the ride are the sole responsibility of the parent or          be aware of other users, ride safely and follow the Highway Code. You should take in to account the
                                                                                               variety of riding styles and abilities, and the likelihood that you will catch up with groups of cyclists
guardian.                                                                                      along the way. Take care not to reduce your standard of cycling when consulting route sheets, joining
                                                                                               in observation activities such as looking for treasure hunt clues etc, and stop in appropriate locations.
CTC, its members, agents and other participants may take photographs during the course         Details of participant: (Please use BLOCK CAPITALS)
of this event, mostly for private use but some may be for local or national publicity
purposes. It may be difficult to ensure that photographs in which your child appears will      First name:………………………… Surname: …………………………………
not be used in any way.                                                                        Address: ...............................................................................................................
                                                                                               ................................................................................. Postcode: ...........................
If you have concerns about this please speak to the leader/organiser.
                                                                                               Tel No: .....................................Email: .................................................................
                                                                                               CTC membership number (if applicable) …………………………………………
                                                                                               Date of birth if under 18: ………………………… (Parental consent required)

                                                                                               Emergency contact details:
                                                                                               Disclaimer for entrants
                                                                                               I agree that I understand and will abide by the terms and conditions required by the CTC for the safe participation
                                                                                               Name: ................................................. Telephone: .............................................
                                                                                               in this activity and to act responsibly and adhere to the rules of the road and countryside. Marshals, if they are
I consent for the child named opposite participating in this cycle ride                        used, are solely to to rider: ..........................................................................................
                                                                                               Relationship indicate the direction and it is my responsibility to ensure that the manoeuvre is carried out
listed. I have read and understood the Notes above.                                            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 the CTC cannot be held responsible for any
                                                                                               personal injury, accident, loss, damage or public liability during the event.
Signature of parent or guardian: ..........................................................    Name: ............................................................. Date: ................................ Signature: ..............................................

                                                                                               CTC rides are covered by Organisers Public Liability Insurance and CTC members are covered by third party
Name (in BLOCK CAPITALS): ..............................................................       insurance, all riders who are not members of the organisations are advised to join the CTC or obtain their own
                                                                                               insurance.
                                                                                               CTC will not disclose the information on this form to any other organisation. If you do not want any photographs
                                                                                               used please notify the event organiser.

								
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