FAMILY RIDE REGISTRATION 2018 How many people are enteringInitially enter the number of riders and the rest of the form will displayNumber of people entering*123456Name of each entrantPerson 1 Name*Person 2 Name*Person 3 Name*Person 4 Name*Person 5 Name*Person 6 Name*Contact DetailsMain adult contact person* First Last The person who is filling in this entry form. Must be 18yrs or over and is responsible for attendance and safety of children entering.Your contact email address* Your contact mobile phone*Payment for Family RideCost $ 0.00 Credit Card MasterCardVisa Card Number Month010203040506070809101112 Year20182019202020212022202320242025202620272028202920302031203220332034203520362037 Expiration Date Security Code Cardholder Name First Accept Family Charity Ride T&Cs and then the PAY NOW Button will display belowYou must accept the Terms and Conditions before the PAY NOW button will display belowTerms and Conditions of Family Charity Ride in Loop the lake* I agree with and understand the terms and conditions of entry By ticking this box I am confirming that I understand and accept the Terms and Conditions and information as published on https://https://www.loopthelake.com.au/family-charity-ride-tcs// - [click to open in a new tab] and that I and any other cyclists I am entering on behalf of are capable of completing this ride safely and are aware of the conditions and requirements for The Family Charity Ride at Loop the Lake participation. Conditions of Entry: I understand and accept we will only be riding the designated route and not be entering public roads I attest that I am physically fit and that my bike is in sound mechanical order prior to undertaking the event. During this event I agree all entrants will wear a cycling helmet, obey the directions of police officers and route marshals and ride with care and consideration of others on the road. In consideration of the Rotary Club of Warners Bay permitting me to enter into and participate in the Loop the Lake event I fully release, indemnify and hold harmless the Rotary Club, its servants and agents from all claims for injury, loss or damage of whatever kind I might suffer as a result of any acts or omissions whether negligent or otherwise of the Club, its servants or agents in relation to the event. Children under the age of 16 must be accompanied by a registered cycling adult at all times and at Police direction can ONLY participate in the 13km ride starting at Belmont South.CommentsThis field is for validation purposes and should be left unchanged.