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australia day ride to remember

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					                                             australia day ride                                         to remember
                                             celebrate on two wheels!
                                             Melbourne Ride & the New Grampians Ride
        Melbourne: Sunday 25th January 2009. Albert Park Boomerang
         Grampians: Monday 26th January 2009. Ararat Boomer ang
                                                         Registration Form
                                               name                                                         MELB RIDE                 GRAMPIANS



                                                                        address



                                                                                                                                 postcode



                       contact phone number                                                            make & model of bike



    rider            pillion          guests                           Registration fees                                      registration number
                                                         $20 bike & rider $15 per pillion $10 per guest
                                                                registration fees include lunch


             payment method                                                   credit card number (please print clearly)



                                        authorised credit card signature                                                           expiry date



                                         Important Terms & Conditions of Entry & Registration

Melbourne riders: Please include registration number so we can obtain toll exemption for you on the Eastlink section of the course.
All riders must be holders of a current license to ride a motorcycle in the State of Victoria. License must be applicable to the class of bike being
entered and that vehicle must be fully registered. Participants agree to comply with all road laws and speed limits plus instructions and conditions
imposed or requested by police and/or marshals assigned to the event by organisers.
Declaration: I hereby agree that I will participate in this event at my own risk and that I, my successors, executors and administrators will release,
indemnify and not instigate any claim, demand or expense against the organisers, their members, agents or sponsors for any personal injury, loss
of life or damage to personal property suffered during or subsequent to the events of the day. I hereby agree to the above terms and to voluntarily
withdraw from the event at any stage if I consider I cannot safely and competently complete the ride or maintain the pace being set by other
participants or in the event of mechanical or other failures of my motorcycle.
I further agree that any flags or national symbols that I display as a participant in this event shall be the national flag of Australia or similar only.

                                 _________________________________________________________________
                                              Participant's Signature

Post or fax your registration to Australia Day Ride to Remember
P.O. Box 2012 Moorabbin 3189 Fax: 03 9555 9969
Registration can also be completed online at
www.australiadayride.com.au

				
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Description: australia day ride to remember