Mt Somers Jeff Gray BMW Mountain Bike Race

6th Annual Race

Download entry form
(left click on above - right click - click print picture)

Online Entry Form

Sunday 17th April 2011

Please ensure the information is correct

Mt Somers Jeff Gray BMW Mountain Bike Race
First Name                           
Surname                              
Address1                            
Address 2                              
Town                          
Postal Code                             
E-Mail            
Phone                            
Cell Phone                             
Race
Sex
Category
Comments
Payment by
If paying by internet for  more than 1 please put names in box     
Direct Payments to CBS Canterbury A/c Number:  031351 0540572 02
Account Name: Mayfield & Districts Lions Club Charitable Trust  
In reference put Surname or last 4 digits of phone number
If paying by cheque send to : Mt Somers Bike Race C/o 5 Millstream Lane Ashburton 7700
Entry Fee     $45  Under 18 $25  Late Entry Fee + $10 on day
Family of more than 3 riders a 10% reduction in Entry Fee

I have read and agree to the above indemnity
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