THE 10^th HERCULES RUN - 2011 ENTRY FORM
 

Lakeland Motor Museum -  2^nd October 2011

ENTRY FORM

 Rider’s Name                                                                                      Bike: Make                                                          

Address                        _                                                                       Model                                                                    

                                                                                                                Year of manufacture                                        

                                                                                                                Registration No                                         _       

Phone                                                                                                    Email                                                                    

Rider’s date of birth                                                                           Pillion’s date of birth                                         

Have you been on the Hercules Run before?     YES / NO

        Advance entry fee:            £10 for bike & rider - £15 including pillion passenger             

                                             On-the-day entry fee         £12 for bike & rider - £17 including pillion passenger

NB entry fee DOES NOT include museum access, discounted fee payable to the museum on the day

Entry fee paid                      £                                             

Advance payments to:  Geoff Madden, Oak Lea Farm, Head Dyke Lane, Pilling, Preston, PR3 6SJ.   

Email: doctormaddman@aol.com  - Tel:  07930 306 009

Terms and conditions for participation:

I am an experienced motorcyclist and I am participating voluntarily in the Hercules Run (‘the event’); I possess the appropriate license and insurance which provides full coverage for myself and my passenger, if carried and third parties; I will ride with due care for myself and others at all times during the course of the event; I , and my passenger, will comply with all instructions from event organisers, police  and safety marshals at all times; I , and my passenger, will wear appropriate clothing, helmet and eye protection in order to minimise the risk of injury in the event of an accident; I accept full responsibility that the motorcycle on which I attend the event is safe and in a good state of repair; I understand and explicitly agree that the event organisers accept no liability for damage to property, personal injury including death, for myself or my passenger, which may occur during  in the event.

BY SIGNING THIS FORM I CERTIFY THAT I HAVE CAREFULLY READ, UNDERSTOOD AND ACCEPTED ITS CONTENTS

Rider’s Signature                                                                               Date                                                                      

Please read Hercules Ride Rules prior to the Run


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