MTB SKILLS DAY SIGN UP SHEET
WHEN? WHERE? TIME: Saturday – 16th May 2009 TBC – Brisbane Metro Region. 9am – 4pm.
COST - $150 – Lunch inclusive with spot prizes
(Payment must be made prior with CHEQUE or DIRECT DEPOSIT-Bsb 112879, acc 067008787. Acc Name RLC SPORT, ST GEORGE BANK)
NAME: ______________________________d.o.b______________ ADDRESS:__________________________________________ PHONE: ____________ MOBILE:__________________ ______
EMAIL:___________________MTBA_licence_#___ Emergency Contact AMOUNT
$150 (mtba) or $165 (non mtba)
Aiden Lefmann P: 0411 805 805 or Anna Beck P: 0411 227 021 F: E: firstname.lastname@example.org W: www.cyclinic.com.au 07 3268 2110 PO Box 108 Alderley, QLD, 4051 Please fax, email or post your sign up sheet/s at least a week prior to the clinic so we can process your registration.
This event is run under the MTBA umbrella through the registered name of Cyclinic, trading as RLC Sport Pty ltd. Riders are required to have a current MTBA license or can purchase a day license upon registration for an additional $15. All riders are required to sign a release waiver. Thanks to our sponsors for their support.