X Scotia 2009 Registration Form
Please return this form asap to xs@shpf.co.uk
Please either print this page, fill in and scan it or rename / amend and send this Word document file to xs@shpf.co.uk
Name ________________________
Address ________________________
Post Code ______________________________
Date of Birth ______________________________
Telephone ______________________________
Mobile ______________________________
Email ______________________________
Medical Information
Please give details of any medical conditions which the event organisers should be aware of. Also details of any medication being taken ______________________________
Your BHPA Number ______________________________
Current Club ______________________________
Must be BHPA Pilot (Hill) rated.
Glider Make and Model___________________________
Colours (main and details eg Blue with red leading edge)________________________________
Emergency Contact
Address ______________________________
Post Code ______________________________
Telephone ______________________________
Mobile ______________________________
Participation Statement
I understand that the X-Scotia event is one that contains a danger of personal injury or death.Participants in this event should be aware of and accept these risks and be responsible for their own actions and involvement.
Signature
Date
Payment
Registration is not complete without payment of the GBP 30 Fee (which Includes T-Shirt, Payment of Entry fee and Friday Meal)
Optional Extra
A new DVD of the entire 2008 X-Scotia race has been produced by John Thomson. It gives the full story of the race, including stunning aerial photography and interviews. It is not compulsory but advisable and is an essential training aid to the 2009 race... only GBP 10
Total Amount you are paying
ENTRY GBP _____
DVD GBP _____
TOTAL GBP _____
Completed forms should be sent to: xs@shpf.co.uk or Gordon Smyth, 83 Marshall Way, Tulibody, Clackmanannshire, FK10 2GA
Ideally please make an electronic transfer of the total amount payable directly to the SHPF bank account.
Bank of Scotland, 1 Ardmillan Terrace, Edinburgh Sort Code: 80 02 28 Account No : 00428340
Remember to put your name into the reference and also send an email to confirm your payment, together with your contact details to xs@shpf.co.uk
Alternatively you can send a cheque made payable to SHPF to Gordon at the above address_
===========================================================
Office use only
Number
Date received
