EmailMe Form - TEAM OF 6 ENTRY FORM

TEAM/CLUB NAME

COUNTRY

CATEGORY

TEAM OF 6 MEN MASTERS A - MALAYSIAN (MYR 3,600.00)

TEAM OF 6 MEN MASTERS B - MALAYSIAN (MYR 3,600.00)

TEAM OF 6 MEN MASTERS A - NON- MALAYSIAN (MYR 5,100.00)

TEAM OF 6 MEN MASTERS B - NON-MALAYSIAN (MYR .5,100.00)

TEAM LEADER/MANAGER
NAME

First Last

NRIC/PASSPORT NO.

EMAIL

CONTACT NO.

Address

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

TEAM VEHICLE REG. NO.

RIDER NO.1
NAME

First Last

NRIC/PASSPORT

DATE OF BIRTH

MM / DD / YYYY

AGE

CATEGORY

JERSEY SIZE

RIDER NO.2
NAME

First Last

NRIC/PASSPORT NO.

DATE OF BIRTH

MM / DD / YYYY

AGE

CATEGORY

JERSEY SIZE

RIDER NO.3
NAME

First Last

NRIC/PASSPORT NO.

DATE OF BIRTH

MM / DD / YYYY

AGE

CATEGORY

JERSEY SIZE

RIDER NO.4
NAME

First Last

NRIC/PASSPORT NO.

DATE OF BIRTH

MM / DD / YYYY

AGE

CATEGORY

JERSEY SIZE

RIDER NO.5
NAME

First Last

NRIC/PASSPORT NO.

DATE OF BIRTH

MM / DD / YYYY

AGE

CATEGORY

JERSEY SIZE

RIDER NO.6
NAME

First Last

NRIC/PASSPORT NO.

DATE OF BIRTH

MM / DD / YYYY

AGE

CATEGORY

JERSEY SIZE

LEGAL NOTICE AND DISCLAIMER

Whilst, the Organizer and Co-organizer of “Malaysian Masters Cycling Tour 2015” that will be held on 3rd-6th of September 2015 (hereinafter referred to as the “Event”) have taken all due care and caution in the preparation and organization of the Event.

However, due to the nature of the sport, the Organizers hold no responsibilty of any kind whether directly or indirectly for any and all loss, damage, cost or expense (including consequential loss, damage or death) arising from or incurred by any cause whatsoever (including negligence of any person) to any person, equipment, vehicle (inclusive of any fittings and accessories) or valuables suffered directly or indirectly by any of the participants, volunteers, officials, sponsors and third party observers during the Event.
Participant in the Event is at the Participant’s own risk.

As a matter of caution, the Participant ought to:
1) have sought medical examination to ensure that the Participant is certified to be medically fit to participate in the Event;
2) wherever applicable, have sought to ensure that the Participant’s insurance policy or policies is not void or voidable as a result of the Participant’s participation in the Event;
3) have ensure that the Participant’s sporting equipment and safety gear has been recently examined by skilled and qualified road bike mechanic, serviced and certified to be fit for use in such an Event.
4) have taken cognizance of the fact that the route designated for this Event is extremely challenging and hence requires much endurance and fitness to surmount.
5) participants are required to wear safety gear including helmet during the challenge. The duty to ensure the correct safety gear is worn rest on the participants. Failure to wear safety helmet will results in the disqualification of the participant. No helmet No ride!

WE HEREBY DECLARE that we have read and fully understood the terms and coditions of participation in the Event and we are willing to join Malaysian Masters Cycling Tour 2015 and will not request for any compesation in case of danger or hurt before/after or during biking.
We are willing to show the evidence with date of birth and photo to prove to the committee and we agree to follow the committee record all the events to be under the copyright of The Race Master Resources we confirmed that all of the above is true.

We agree