1 km time trial

Any bike will do!
Sunday 31 October, 1999
From 12.00 am
Reg'n close at 11:30 am
London circuit, Civic

$3 Entry
Entries Close 27th October
For 5 to 15 years old
Part of Canberra’s Classic Cycle Sunday

ENTRY FORM
Print this form and mail it to the address below with all your details included.

Name: ……………………………………………………..... Gender: M / F
Age: (at date of event) ….……
Address: ……………………………………………………. Post code: ……………..
Phone: ………………………….. School: ………………………………………..
Parent/Guardian signature: ………………………………… Date: ………………….
(Entries accepted on the day. $2 Late entry fee apply)
Declaration:
I, the above-signed, in consideration of and as a condition of entry in the 1999 Street Heat, for myself, my heirs, executors and administrators, hereby waive all and any claim, right or cause of action which I might otherwise have arising out of loss of my life or injury, damage or consequent upon my entry or participation in the said event. This waiver, release and discharge shall be and operate separately in favor of all persons, corporations and bodies involved in or otherwise engaged in promoting or staging this event.
I have no medical impairment which may be detrimental to my health and my ability to participate.
For further information phone John Armstrong 02 6241 4930 or Graham Toohey on 02 6247 1733
Send entries to
ACTCF Street Heat, PO Box 3238, Canberra City, 2601

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	Any bike will do! Sunday 31 October, 1999 From 12.00 am Reg'n close at 11:30 am London circuit, Civic
$3 Entry Entries Close 27th October For 5 to 15 years old Part of Canberra’s Classic Cycle Sunday

ENTRY FORM Print this form and mail it to the address below with all your details included. Name: ……………………………………………………..... Gender: M / F Age: (at date of event) ….…… Address: ……………………………………………………. Post code: …………….. Phone: ………………………….. School: ……………………………………….. Parent/Guardian signature: ………………………………… Date: …………………. (Entries accepted on the day. $2 Late entry fee apply) Declaration: I, the above-signed, in consideration of and as a condition of entry in the 1999 Street Heat, for myself, my heirs, executors and administrators, hereby waive all and any claim, right or cause of action which I might otherwise have arising out of loss of my life or injury, damage or consequent upon my entry or participation in the said event. This waiver, release and discharge shall be and operate separately in favor of all persons, corporations and bodies involved in or otherwise engaged in promoting or staging this event. I have no medical impairment which may be detrimental to my health and my ability to participate. For further information phone John Armstrong 02 6241 4930 or Graham Toohey on 02 6247 1733 Send entries to ACTCF Street Heat, PO Box 3238, Canberra City, 2601