British Trials Cup 2012
ENTRY FORM
Food will be available at this event.
All riders must wear a helmet when on bikes.
British Trials Cup 2012 - Round 1 - AMCA Permit Applied for
DATE: Sunday 18th March 2012 TIME: 10.30am (sign on from 9.00am, pre-trial briefing 10.15am)
VENUE: Bracken Rocks, Holloway, Derbyshire

PAPER ENTRIES: Closing date Monday 12th March 2012. Entry fee £20.00, cheques payable to Biketrial and must be sent with this entry form. Entries to be address to Secretary of the Meeting.
ON-LINE ENTRY: is available on www.biketrialuk.co.uk until midnight on Monday 12th March 2012; an additional £1 is charged to cover PayPal costs.
ENTRY FEE: £20.00 Payment must be received with the entry. Entries without payment will not be accepted.
If entering on-line with this form, please make payment by clicking on the "PayPal Payments" button on the website "Events" page. You do not need to have a PayPal account and can make payment directly from a debit or credit card, or from your bank account. Please note the Payment ID reference to include on this entry form below.
LATE ENTRIES: may be accepted at the discretion of the Secretary, entries on the day may be accepted but will incur an additional £5.00 fee.
CANCELLED ENTRIES: Entries cancelled up to the day before the event will receive a full refund.
Clerk of the Course: Mick Carthy Stewards: George Eyre, Brian Wright
Secretary of Meeting: Barbara Wright, 27 Midland Terrace, Hellifield, Skipton, North Yorkshire, BD23 4HJ. Tel: 07850 505298
This event is the first round of the British Trials Cup 2012 series. The event will be run according to the Biketrial Federation rules as reproduced on the website www.biketrialuk.co.uk. A printed copy can be obtained from the Event Secretary if required.
Entry Form: British Trials Cup Round 1 (2012) Venue: Bracken Rocks, Holloway, Derbyshire
DECLARATION: I, the undersigned apply to enter the event described above and in consideration thereof:-
* I hereby declare that I have had the opportunity to read, and that I understand the Biketrial Federation Rules, and Supplementary Regulations as have or may be issued for the event, and agree to be bound by them.
* I further declare that I am physically and mentally fit to take part in the event and am competent to do so.
* I confirm that I understand the nature and type of event I am entering and its inherent risks and agree to accept the same notwithstanding that such risks may involve negligence on the part of the organisers or officials.
* I confirm that the bicycle as described below which I compete on shall be suitable and proper for the purpose.
* I agree that I am required to register my arrival by signing-on at the designated place not less than 30 minutes prior to commencement of my practice or first competition, whichever occurs first.
Acknowledgement of the risks of the sport: I understand that by taking part in this event I am exposed to a risk of death, becoming permanently disabled or suffering some other serious injury and I acknowledge that even in the event that negligence on the part of the organiser, the promoter, the organising club, the venue owner, or any individual carrying out duties on their behalf were to be a contributory cause of any serious injury I may suffer, the dominant cause of any serious injury will always be my voluntary decision to take part in a high risk activity.
I have read the above and acknowledge that my participation in the sport is entirely at my own risk.
Signature of rider ..............................................................................
Parental Agreement (if under 18): I hereby declare that I have had the opportunity to read, and that I understand the Biketrial Federation Rules and Supplementary Regulations as have or may be issued for the event, and agree to my son/daughter taking part in this event. I have read the "Acknowledgement of the risks of the sport" that my son/daughter has signed and agree that any injuries he/she may suffer will be by his/her voluntary decision to take part in a high risk activity.
Signature of Guardian (if under 18) .............................................................................

*I am unable to attend this event, my son/daughter will be in the care of who has agreed to be responsible for him/her throughout the event.
Name:
Address:
Postcode:
Tel No:
Date of Birth: Age:
Bike make
Observer:
Each observer that is used will receive refreshments during the day and a thank you gift. Your help is really appreciated.
 
Please mark class entered with a X:-
None-competitive Please state None-competitive route
Primary White route (one class all wheel sizes)
Novice Green route (one class all wheel sizes)
Ladies ½ Green ½ Blue routes (one class all wheel sizes)
Intermediate Blue route (one class all wheel sizes)
Senior (over 28) Blue route (one class all wheel sizes)
Cadet ½ Blue ½ Red routes (one class all wheel sizes)
Expert Red route (2 classes 20" & 24/26")
Elite* ½ Red ½ Yellow routes (2 classes 20" & 24/26")
UCI World Elite* Yellow route (one class all wheel sizes)
*Selected riders only  
Wheel size 20", 24/26"
PayPal transaction ID No: (payment must be made with this form)
Email address:
You must provide a genuine email address for this form to work and for your entry to be processed.

If under 18 it is essential that we have your parents signature on the agreement above. If they are not coming to the event with you, print this form before clicking on "Enter Event", get them to sign the agreement and bring it with you to the event. The nominated person must sign you on at the event.
 
Click to enter this event:
DIRECTIONS TO BRACKEN ROCKS, Holloway:- A6 between Matlock and Ambergate/Belper to Whatstandwell. Take the turning immediately next to the Derwent Arms pub in Whatstandwell, following this 150 yards uphill. Take the small left hand turn into Robin Hood Road. Approx 1½ miles, turn right into Bracken Rocks. Post Code: DE4 5AS
CAMPING:- Birchwood Farm Caravan Park, Whatstandwell Telephone: 01629 822 280 (Advise pre-booking; space for 30 tents) TOURIST INFORMATION:- Matlock Bath Tourist Information Tel: 01629 55082
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FIRST AID:- First Aid will be available on site during the event. Outside the event, first aid is available for minor injuries at The Whitworth Hospital, off the A6 at Darley Dale (open 24 hours). Tel: 01629 580 211 Post Code: DE4 2JD