FORM – to be completed by all riders
I wish to enter the 200
km randonnee at Banyo to be held by The Audax Club of Australia on _28_/_07_/_2007 I understand the nature and method of conduct
of the event.
I agree to abide by the Ride Rules of The Audax Club of Australia.
I agree to comply with the traffic and road laws and regulations of the
State/Territory in which I am travelling as they affect the use of a bicycle.
I fully understand and agree that I am entering this event entirely at my own
risk and accept without exception full and complete liability for all and any
risks and will not hold responsible nor make claim against The Audax Club of
Australia, its committee members, agents or servants for any loss, damage or
injury however caused in relation to my participation in this event.
I understand that I am required to comply with the lighting requirements set
out in the Ride Rules. These
requirements apply for a ride on which any part of the maximum time is at night
(ie, between sunset and sunrise), and include:
efficient front and rear light and a rear red reflector attached to the bicycle
(and spare front and rear lights)
lights switched on at all times of darkness or low visibility
- wearing a
reflective vest or bandolier at all times of darkness or low visibility.
SIGNATURE______________________________ DATE / /
PHONE (h) _________________ (w)___________________(mob)_________________
CONTACT: NAME & NUMBER ________________________________
FOR TEMPORARY MEMBERSHIP – to be
completed only by riders who are not members of The
Audax Club of Australia or Cycling Australia
I wish to apply for temporary membership of Audax Australia. I understand that this membership applies for
the duration of this ride.
entry fee (200) $ 15 $ _______
membership fee $ 5 $ _______
Medallion (200 – 1000 km) $ 8 $
badge (50 – 200 km) $ 5 $ _______
entry fee $
5 $ _______
TOTAL COST $
PARENTAL CONSENT – for riders of less
than 18 years of age
have read and understood the information contained on this entry form. As the parent/guardian of ___________ (name),
I consent to my child taking part in this ride organised by The Audax Club of Australia