Essex Trials and Jump Centre
New Riders Form
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First Name |
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Last Name |
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Date of Birth |
Age |
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Address |
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Town |
County |
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Post Code |
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Telephone |
Mobile |
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Emergency Contact details
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First Name |
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Last Name |
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Relationship to rider |
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Home Phone |
Work Phone |
Disclaimer
I hereby apply to become a rider at the Essex Trials and Jump Centre as indicated above. I or my parent/guardian accept and agree that neither the organizers, officials, the landowners, sponsors or fellow riders shall be liable in any way, or in any circumstances for any damage or injury that I may suffer during, in connection with, or as a result of taking part in cycling activities at The Essex Trials and Jump Centre (ETJC). I will abide by the rules of the ETJC. I agree that I participate in this activity entirely at my own risk and that I must ride in a manner which is safe for all others and myself. I also declare that the bicycle I will ride is in good working order and properly maintained. I shall wear the necessary protective clothing suitable for the activity including a helmet and I will not go beyond my capabilities.
I have read and understood all Rules and Regulations as stated
overleaf.
(This must be completed for a successful application)
Please tick if you would like to hear about our latest events
(This does
not affect your application)
