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Cromwell Summer Series Entry Form:

Bannockburn Gutbuster Pub to Pub

I wish to participate in the 2011 Adventure Crazy Pub-to-Pub Bannockburn Gutbuster MTB Race.

Online entries close on 18th November 2011. Late entries can be made on the day of the event.

Competitor Information

First Name:
Surname:
Address:
City:
Phone:
Email:
(For Summer Series only)
Category:
I would like transport:
from Bannockburn to the start at Garston @ $20

Tee Shirts

Please supply me with Tee Shirt(s) @ $30.00 each.
Size:
Colour:
Number:
Total:



Risk Disclosure Acknowledgement: In entering the 2011 Adventure Crazy Pub-to-Pub Bannockburn Gutbuster MTB Race event I understand there are risk involved in the activities I will be undertaking. I also understand that an unpredictable or uncontrollable event may occur that could possibly cause me serious harm or death. I am aware of the implications of my voluntary participation and the consequences should I ignore the organisers 'Safety Management System' , 'Entry Form' and briefing, including procedures and directions regarding the use of any safety equipment. I acknowledge that the organisers will take all reasonable and practicable steps to keep me safe while I am involved in the event. However, I accept full responsibility for my own actions or inaction. I allow sponsors / organisers to use my name and/or photograph for promotional purposes.
I have read and understood the Risk Disclosure above:


Additional Information

Yes, I would like to receive a Ground Effect catalogue in the mail and go in the draw to win $250 worth of kit!
I wish to receive other sponsors' information