Forty Plus Cycling Club

125km Tour of Essex

Thursday, 9th July, 2009

Joint entry form (for paid-up Forty-Plus members only)

FULL NAME (block capitals please)...................................................................

SPOUSES FULL NAME (if entering)...................................................................

ADDRESS....................................................................................................

Post Code...................Tel. No.......................

Entry Fee: £3.50 per person.

Please make cheques payable to the Forty Plus C.C. and write your post code on the back.

You will be sent a route sheet before the event.

Closing date for entries: Thursday 2nd July 2009 (no entries will be accepted after this date)

PLEASE NOTE THAT THE CLUB CANNOT BE HELD RESPONSIBLE FOR ANY LEGAL PROCEEDINGS THAT MAY ARISE CONCERNING RIDERS IN THE EVENT. YOU ARE ADVISED TO BE COVERED WITH THIRD PARTY INSURANCE.

Return this form with the appropriate fee (£3.50 per person) and a stamped, self addressed 9” x 4” envelope to: Peter Sears, 41 Spalding Way, Chelmsford, Essex CM2 7NZ - Tel. 01245 475310