Chris Spin 2017 Application Form

Please fill out this form if you wish to take part in this year’s ride which will take place on Saturday 13th May 2017.

Name
Email - Invalid email address
Mobile number
Emergency contact name
Emergency contact number
I would like to take part in the


Age


Disclaimer
I understand that the event organisers and Prostate Cancer UK cannot be held responsible in any way for loss or injury to me, or any other party, however arising or for any property lost or damaged as a result of my participation in this charity event. I declare that I am medically fit and understand that I enter this event at my own risk.
If under 16 years old - Name of Parent/Guardian
If under 16 years old - Parental Disclaimer
I am the parent/guardian of the above-named child and I am happy with their participation in this charity event and endorse the above declaration on their behalf.

Posted in Application Forms, General News

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