RICHMOND FUN RIDE

INDEMNITY FORM

I, the undersigned, hereby indemnify Richmond Fun Ride, Pied Piper Pre Primary School, their Agents, Richmond Country Club, their Members, Agents, Employees, Richmond Municipality, its representatives, officals and associated persons and the Land Owners on whose land I ride, against any losses, injuries, fatalities or damage whatsoever to myself or my property, whilst participating in this ride, regardless of the cause. I hereby agree to enter at my own risk and agree that this is a fun ride and not a race. I am aware of the risks and possible dangers associated with a ride of this nature and confirm that I voluntarily assume all such risks.

My signature below confirms that I have read and noted the contents of this indemnity and will adhere to the rules and regulations as laid out in both pages of this indemnity form.

DO NOT deviate off the marked route and DO NOT under any circumstances ride through or over any crops, grassland or any terrain that is not part of the route. You are riding on PRIVATE land, please respect the owners property. Failure to adhere to this request may lead to liability for the subsequent damage caused.

DATE : ______

NAME: ______AGE: ______

ID No: ______

ADDRESS: ______

______

CONTACT NO: ______E-MAIL ADDRESS: ______

CONTACT PERSON AND NUMBER (In case of emergency):

______

MEDICAL AID NAME: ______MEDICAL AID NO.: ______

MEDICAL AID PLAN: ______

BIKE: (make & model): ______

SIGNATURE: ______

PARENT / GUARDIAN: ______(In case of minor under 18 years)

Tick relevant box below:

PRE ENTRY BIG TRACK R200 / PRE ENTRY KIDS TRACK R80
LATE ENTRY BIG TRACK R200 / LATE ENTRY KIDS TRACK R80

NB PRE ENTRY FEES – INDEMNITY AND PAYMENT MUST BE RECEIVED BY 4PM

THURSDAY 11THAUGUST 2017.

N.B. SIGN IN (On completion of ride):

NOTE: ENTRIES NOT FILLED IN COMPLETELY WILL NOT BE ACCEPTED.

COURSE MARKINGS, SIGNS & RULES

The course is marked with RED day-glo tape ON THE LEFT HAND SIDE.

If you find SINGLE stickers on your right, you are going the WRONG WAY.

STOP immediately, check for other riders, turn around and proceed in the right direction.

CORNER MARKING.

Corners are marked with TWO sets of double stickers, one above the other. The first set is approx 30 meters before the corner, the second set at the turn.

For a left turn, the stickers will be on your LEFT.

For a right turn the stickers will be on the RIGHT.

This is the ONLY TIME YOU WILL ENCOUNTER STICKERS ON THE RIGHT SIDE OF THE COURSE.

DANGER AREAS.

Dangerous areas such as holes, dongas, no go areas, blind turns etc will be indicated by RED & WHITE CANDY TAPE. If you see tape, SLOW DOWN and LOOK OUT. Danger zones will also be marked with CAUTION BOARDS. PAY ATTENTION TO WHAT THEY INDICATE.

STOPPAGES, BREAKDOWNS & INJURIES

This is not a race, if you see a rider in need of assistance, stop and see if they’re OK. If you stop or break down, DO NOT TURN BACK ON THE COURSE!

Pull off the course and stop another rider for assistance or wait for a marshal to assist you. Alternatively, phone one of the emergency numbers listed below or supplied to you at registration.

RIDING TIPS, DO’S & DON’TS.

Marshals must be obeyed at all times and recovery vehicles have right of way at all times. Novice Riders, it’s advisable to ride in a group, you’ll then have some one to help you through any tricky stuff and you can help them. You also have someone to enjoy the ride with. All signage on the course is there for a reason. STOP at stop boards, SLOW DOWN at caution boards and anything with candy tape is DANGEROUS or a NO GO zone so stay away.

BANKING DETAILS

Account Name : Pied Piper Pre Primary

Bank : First National Bank

Branch : Richmond Branch Code : 221826

Account Number : 53563852012

Current Account

Reference : Your Name and Surname

Fax your payment confirmation with your indemnity form to 0862664377 or email

We will confirm receipt of all entries via email. If you do not receive an email please ensure that you bring your forms with you.