SPIUK - KUIPS

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..Stratford CC Spiuk Road Race
WOMENS TEAM SERIES ROAD RACE

ONLINE RACE ENTRY FORM

To enter the Stratford CC/SPIUK WOMENS TEAM SERIES ROAD RACE please fill in the details below, you will then be directed to the Spiuk Shop to pay online.
RACE:
Title:
First Name:
Second Name:
Date of Birth:
Club/Team Name:
Email:
Telephone:
Address:
Town:
County
Postcode:
BC Licence No:
UCI No :
Category:
Registered Colours :
Key Sponsors :
Are you prepared to be nominated as a reserve:
Licence points gained This Year:
Premier points gained Last Year:
Premier points gained This Year:
Licence points gained Last Year:

Best Performances in BC or UCI sanctioned events this year and Last year

Spiuk Sports: 87 Old Town Mews Stratford Upon Avon Warkwickshire CV37 6GR
Mobile: (+44) 07815 731664 Fax: (+44) 01789 268570