2006 Time Trial Series Entry Form
NOTE: All Time Trial participants must complete the Time Trial Series Entry Form
(below) and have a current Chinook Membership (
printable web page
or
PDF file).
These can be completed and mailed or can be brought
to the Time Trial Series.
Mike Robinson
Documents Officer/Chinook Cycle Club
(509)727-2797/mrrobinson945@aol.com
CHINOOK CYCLING CLUB
2006 Time Trial Series
Entry Form
Name:________________________________________________________________________________
Street Address: _________________________________________________________________________
City: ______________________ State: ______ Zip: ________________
Phone (home) _________________ (work, optional) _________________
E-mail address: _______________________________________________
Racing age (age at the end of December 31, 2006: ______
Notify in case of emergency: ______________________________________________________________
Emergency phone: _____________________________
Fees: ____ Full series ($15.00)
____
Individual ride ($1.00)
(Checks may be made payable to: Chinook Cycling Club)
I certify by my signature below that I am a current member of the Chinook Cycling
Club, and have read and agree to the waver and release required for membership in
the Chinook Cycling Club.
Signature ____________________________________ _____________________________________
(Guardian, if under
18)
Date ________________________
NOTE: 1. Each ride must be ridden within the
time window listed on the ride schedule. Rides outside the ride window are
eligible for ½ participation points only (if ridden on day of ride, on ride course).
Rides must be completed to be eligible for points.
-
The wearing of an ANSI, SNELL Institute, or Consumer Products Safety Commissions
approved helmet is required for time trial participation.
-
The roads are not closed to traffic. Please ride safely and stay out of traffic
before and after your ride. No traffic control is provided. Each rider
is solely responsible for individual safety.
Form prints onto an 8.5" x 11" sheet of paper. Make checks payable to Chinook Cycling
Club and mail to:
Chinook Cycling Club,Inc.
2220 S. Dawes Ct.
Kennewick, WA 99338
(509)727-2797/mrrobinson945@aol.com
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