CLUB CHAMPIONSHIP ENTRY FORM

ENTRY FORM FOR CYCLE CLUB SUDBURY

CHAMPIONSHIP 10mile TT on 26 JULY 2012

C.C.S. 1st Claim members who wish to ride the C.C.S. Championship 10 Mile TT

Event on Thursday 26 July 2012 please fill in this entry form and return to either

Stewart Kirk, Robin Weaver or Brian Webber by 19 July 2012 at the latest.

NAME

AGE

DOB

If under

19 years old

Your fastest time on the Lavenham   course for the 2011 season

Your fastest time on the Lavenham   course for the 2012 season

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