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The Royal British Legion Riders Branch – BR 3542
THE 2015 RBLR 1000
ENTRY FORM
This form must be completed in BLOCK CAPITALS, signed and returned to:
WHITE DALTON MOTORCYCLE SOLICITORS, VICTOR HOUSE, PITSTONE GREEN BUSINESS PARK,
PITSTONE, LEIGHTON BUZZARD LU7 9GW
th
by 28 May 2015 accompanied by the entry fee of £20.00 plus £10.00 per nominated passenger.
Please make cheques payable to RBLR and endorse the rear of the cheque RBLR 1000.
Please complete as much information as possible. Fields with an asterisk are required. The more information you
provide at this stage the easier it is for us to administer the event and issue IBA certificates immediately after you have
finished.
1. Rider Details
Forenames *
Surname *
House Name / Number *
Street Name *
Town *
County *
Postcode *
E-Mail
Tel Home *
Tel Mobile
Date of Birth *
IBA Number (if known)
Proceed to section 2 >>>
2. Pillion Details – if applicable
Forenames
Surname
House Name / Number
Street Name
Town
County
Postcode
E-Mail
Tel Home
Tel Mobile
Date of Birth
IBA Number (if known)
Proceed to section 3 >>>
3. Emergency contact details
Please provide at the very least a name and telephone or mobile number of someone whom we
can contact on your behalf in case of emergency
Name *
Tel / Mobile number *
Address
If you have a pillion and their emergency contact details will be different from yours please
provide them below
Name
Tel / Mobile number
Address
Proceed to section 4 >>>
4. Motorcycle Details
We need these details when we prepare the IBA certificate, to keep track of riders and to compile
statistics at the end of the ride
Make / Model *
Actual CC *
Registration Year *
Registration Number *
5. Route Planned
Please tick the route you are planning on taking. If you don’t yet know which route please email
verifications@ironbutt.co.uk with confirmation of your route choice as soon as possible.
North Clockwise NC
North Counter-Clockwise NCC
South Clockwise SC
South Counter-Clockwise SCC
Undecided
Note that if you are going to choose your own route then there will be an extra fee applied. Please contact
verifications@ironbutt.co.uk for information on this.
Proceed to final section >>>
6. Declaration
This event is held under the Iron Butt Association SaddleSore 1000 rules which can be found at
http://www.ironbutt.com./ridecerts/getdocument.cfm?DocID=1 and any Final Instructions issued for the meeting which
will be published at http://www.rblr.co.uk/RBLR1000.html and verbally briefed prior to the event.
ARE YOU AND YOUR BIKE UP TO THIS?
You are volunteering to take part in an endurance ride. It is not for novice riders. It is a hardcore event. By the end of it
you will be knackered. Your bike will have had one of the hardest runs of it’s life. You may well be cold, wet and
miserable. We cannot control what you do or what anyone else on the road might do. We cannot control you, your
bike, the roads, or the other road users. If you are not up to it, do not do it. If you are involved in a crash, then the
RBLR’s Branch Solicitors will do what they can to help. If you can’t take a joke or take a risk then bail out now. You
are mostly ex Services personnel. You know what being cold and tired is all about.
We are asking you for £20 so the RBLR does not end up out of pocket. You are responsible for your own riding and
the state of your own bikes. We will not check your bikes, documents or anything else. Bikes are dangerous things. If
you don’t fancy the risks inherent in riding a bike for 1000 miles then stay at home. Most of you will be wearing the
RBLR Crest on your person, so do not ride in a way which brings either the Branch or The Legion into disrepute.
Observe speed limits (which are a limit not a target), ride considerately and ride safely.
Entry Declaration:
I / we the undersigned apply to enter the event described above and :I / we hereby declare that I/ we have had the opportunity to read, and that I / we understand the IBA rules for
SaddleSore 1000, have paid particular attention to the IBA Archive of Wisdom
http://www.ironbutt.com./tech/aowprintout.cfm and any Supplementary Regulations as have or may be issued for the
event, and agree to be bound by them.
I / we further declare that I am / we are physically and mentally fit to take part in the event and I am / we are
competent to do so.
I / we confirm that I / we understand the nature and type of event we are entering and its inherent risks and agree to
accept the same
I / we confirm that the machine(s) as described which I / we use shall be suitable and proper for the purpose.
I / we confirm that if any part of the event takes place on a public highway, the machine(s) described shall be insured
as required by the Road Traffic Acts, or equivalent legislation, and that it / they will comply with the regulations in
respect thereof.
I / we agree that I am / we are required to register our arrival by “signing on” at the designated place not less than 30
minutes prior to commencement of the event
I / we enclose the entry fee of: £ . . . . . . . . . . . . . .
Acknowledgement of the risks of motorcycling:
I / we understand that by taking part in this event I / we are exposed to a risk of death, becoming permanently disabled
or suffering some other serious injury. I / we have read the above and acknowledge that my / our participation in
motorcycling is entirely at my / our own risk.
Rider`s signature:
Date
Passenger `s signature:
Date