I declare that:

My accepted entry into the Event will not be transferred to another entrant.

I am in an appropriate physical condition to participate in the Event, given the known parameters of the Event (such as the length, time, physical demands and environmental context).

I have taken medical advice on any pre-existing medical conditions, and confirm that it is medically safe for me to participate in the Event.
I acknowledge that there are risks involved in the Event. I fully realise the dangers of participating in the Event, and fully assume the risks associated with my participation and my wellbeing and safety during and after the Event. I understand and acknowledge that the Event organisers (including all officials and event volunteers) provide no warranties, regarding my wellbeing and safety.

I understand and agree that situations may arise during the Event, which may be beyond the immediate control of the Event organisers (including all officials and event volunteers).
I will participate in the Event, in a manner that does not endanger either me or others.

I agree that to the extent permissible by law, the Event organisers (including all officials and event volunteers), the sponsors and other parties associated with the Event, have no liability to me whatsoever for any direct or indirect loss, (including, but not limited to injury or death) sustained by me during or in any way related to my participation in the Event.

I authorise the use of my name, voice, picture and information on this entry form in any broadcast, telecast, promotion, advertising, and in any other way, without payment to me or any other form of compensation.

I agree to comply with the rules, and regulations pertaining to the Event.

I agree to follow all reasonable safety instructions provided to me by the Event organisers, (including all officials and event volunteers) before, during and after the Event.
I consent to receiving medical treatment in the event of illness or injuries suffered during or immediately after the Event.

In the event of any ‘act of God’ conditions causing a cancellation of the Event, I agree that my a portion of my total entry fee or my total entry fee is not transferable or refundable.
I agree to submit a medical certificate if requested by the Event organisers.

I hereby acknowledge and accept that the event in which I will be taking part, i.e. a UCI Gravel World Series qualifier, belongs to and is sanctioned by the Union Cycliste Internationale (UCI).

Regardless of whether I hold a valid licence (in the sense of art. 1.1.001 of the UCI Regulations), I hereby acknowledge and accept that by taking part in the relevant event, I am bound by the UCI Regulations, in particular in respect of disciplinary matters.

I hereby acknowledge and accept that by taking part in the relevant event, the UCI may use and exploit all my personal data necessary for the organisation of the Series, including my first name, last name, date of birth, email address, phone number, UCI ID, my image on picture, video – or on any other support – taken during the event concerned.

I hereby acknowledge and accept that my personal data disclosed to the organiser of the event for the purpose of registering to the relevant event, shall be provided to the UCI and to the series licensee, Golazo Sports NV, for the purposes of governing the sport of cycling and managing the Gravel World Series.

I take note that I may contact the UCI (data.protection@uci.ch) or Golazo Sports NV (privacy@golazo.com) at any time in order to exercise any of my rights and, in particular, the rights to request access, rectification or deletion of some of my personal information.

Understood and agreed upon



Name: ____________________



Place: ____________________



Date: ____________________



Signature: ____________________

(if form presented electronically, acceptance given by ticking relevant box)