Men

National Road Series Teams (NRS)

The Battle on the Border (with support from the new CQEvents Manager) has changed the manner in which NRS teams can enter and will trial these procedures to reduce expenses for the team managers.

NRS teams are traditionally late to enter for various reasons including unknown rostering of riders; and therefore need increased flexibility to enter teams.

  1. Team managerscan register via this manual form and the team is listed as competing;
  2. To secure rider positions (without names) on the start list, the team manageris to make payment for the number of rider positions;
  3. The minimum number of men (5) and women (3) per team must be paid to secure the riders on the start list. Payment is only on the basis of a per rider entry fee as shown below;
  4. Team managers can then add / change rostered rider names to this manual form 21 days in advance;
  5. Refunds are available as per the terms and conditions; and payment can be made with vouchers, credit cards or by cheque.
  6. A tax invoice is available from CQ and can be requested on this manual form.
  7. Additional riders maybe added to reach the maximum number of riders for Men (7) and women (5), but they will be charged at the set ratesat the time of entry.

Battle Enquires

Mike Crawley

0402 226333.

BATTLE ON THE BORDER 28 to 31 May 2015 / New Year Rate to 15 February 2015 / To 5 April 2015 Rate / To 30 April 2015 Rate / 1 May 2015 Onwards Rate
NRS Men / $249 *save $70 / $249 *save $70 / $279 *save $50 / $319

TEAM ENTRY FORM

TEAM MANAGER

NAME: ______LICENSE CATEGORY: ______LIC #: ______DOB:______

CLUB: ______PHONE: ______
EMAIL: ______EAM

I agree with and accept the Declaration as shown below: SIGNATURE: ______

TEAM

ETEAM NAME: ______

MENS: [ ]

WOMENS: [ ]

EXPECTED NUMBER OF NIGHTS OF ACCOMMODATION: ______

TOTAL NUMBER OF PERSONS ATTENDING WITH TEAM: ______

RIDERS

Reserves in asterisk (*)Please type fill if possible.

Men’s team minimum of 4 riders and maximum of 7. Women’s teams minimum of 3 riders and maximum of 5.

SURNAME (Caps) / First Name / License Number / Club / Division
*
*
*

PAYMENT DETAILS

Credit Cards:Please ensure that 16 numbers plus expiry date are included. (MC, BC, Visa only)

CARD NUMBER:______/ ______/ ______/ ______EXP: ___ / ___ CCV: ______

TOTAL ENTRY FEES TO BE CHARGED: $ ______

CARD HOLDER NAME:______SIGNATURE: ______

TAX INVOICE REQUIRED: [ ] EMAIL TO: ______

DECLARATION:-

In consideration of the acceptance of this entry in the competition by the Queensland Cyclist Association Inc hereafter called Q.C.A. and or its agents:

1.My team agree to comply with all the rules and regulations & event instructions of Q.C.A and their directors

2.For myself, my executors, administrators, heirs, next of kin, successors and assigns, I hereby (a) waive and release all claims on behalf of my team I may have against Q.C.A their officer, directors, event committee, volunteers, employees, agents and sponsors, the State of Queensland, the local shire council or any one or more of them or their executors, administrators, heirs, next of kin, successors or assigns ('the release') including any and all claims for damages caused by the negligence of any of the above arising out of my participation in the event or it's related activities, together with any costs including attorney's fees that may be incurred as a result of such claim whether valid or not, and (b) indemnify and hold harmless the releases and each of them against any such claim that I or my guests or anyone or more of the executors, administrators, heirs, next of kin, successors and assigns may have or assert and against any costs including attorney's fees with respect thereof.

3.The team acknowledges that it is the responsibility of individuals to take due care of their possessions and sporting equipment during the competition and its related activities.

4.The team acknowledges that participation in the competition comes with it potential hazard. I therefore release the promoting club, CQ directors, events committees, members, volunteers, employees, sponsors of any liability resulting from injury or death during the event or its related activities.

5.I hereby consent to medical treatment being provided for team members which may be deemed advisable in the event of injury, accident and or illness during the competition.

6.Entries must be received by the advertised closing date. Late entry subject to the Late Entry Policy (CQ website)

7.A current racing license must be produced at registration at least 30 minutes before race start for each rider.

8.Riders compete at their own risk. Fines will be imposed for race collusion and unsatisfactory performance.

9.Withdrawals and refunds will be as per the QSMsports terms and codntions.

QUEENSLAND CYCLIST ASSOCIATION INC. / PH (07) 3390 1477
PO BOX 4115 / FX (07) 3390 2852
GUMDALE QLD 4154 / E