Le Petit Depart Team Entry
Booking Form
Team Name:
Please complete with each riders details, which ride distance and the payment amount. £20 for the 38
mile Recreational Ride (includes T-shirt or post ride meal) or £30 for the 80 mile sportive ride (includes Tshirt or post ride meal). Riders must be over 16 to participate. Please ensure you select the correct Entry
Fee for your chosen ride.
Entry 1
Title:
First Name:
Surname:
Gender: Female
DOB:
E-mail:
Entry 2
Title:
First Name:
Surname:
Gender: Female
DOB:
E-mail:
Entry 3
Title:
First Name:
Surname:
Gender: Female
DOB:
E-mail:
Entry 4
Title:
First Name:
Surname:
Gender: Female
DOB:
E-mail:
Entry 5
Title:
First Name:
Surname:
Gender: Female
DOB:
E-mail:
Postcode:
Emergency Contact Name:
Emergency Contact Number:
Which ride, 38 or 80:
Entry Fee £20/ £30: 0.00
Postcode:
Emergency Contact Name:
Emergency Contact Number:
Which ride, 38 or 80:
Entry Fee £20/ £30: 0.00
Postcode:
Emergency Contact Name:
Emergency Contact Number:
Which ride, 38 or 80:
Entry Fee £20/ £30: 0.00
Postcode:
Emergency Contact Name:
Emergency Contact Number:
Which ride, 38 or 80:
Entry Fee £20/ £30: 0.00
Postcode:
Emergency Contact Name:
Emergency Contact Number:
Which ride, 38 or 80:
Entry Fee £20/ £30: 0.00
Please ensure you have selected the correct Entry Fee for your chosen
ride. Closing date for entries is Friday 19th May.
Total: £ 0
Payment Options
When paying online or BACS, please use the following reference: “LPD” and then your Team name
ONLINE – Card Payment via our secure online payment system http://bit.ly/1idwWxl
CHEQUE – Single cheque, made payable to “Craven District Council” – please post with entry form
BACS – Single payment, paid direct to Craven District Council bank account:
Lloyds Bank Sort Code: 30-91-12 Account No: 00654605.
Please pay when you post the form to the Council.
Refund Policy
Refunds are at the discretion of the Event Organiser. Entry transfers can be made at a small
administration charge.
Form to be returned to: Bruce Dinsmore, Craven District Council, 1 Belle Vue
Square, Broughton Road, Skipton, BD23 1FJ or [email protected]
The Event is run under the British Cycling event management system and all entrants
should be aware of the following Terms and Conditions:
http://www.britishcycling.org.uk/search/article/Rider-Ts-and-Cs-0
All Team entries will receive a confirmation email and monthly event entry updates.
Data Protection
Under the Data Protection Act 1998, your data collected from this form will be used solely
for the management and organisation of the event. We will not pass on your data to third
parties.
Working in partnership to put
on one amazing event