<p>Auckland Cycle Touring Association Ride Register & Emergency Contact Details Ride Details: Leader: Tail End Charlie :______</p><p>Date: Distance: km Ride to ______Weather: ______</p><p>The purpose of this form is to provide the Ride Leader with emergency contact details for each rider should the need arise. After the ride, it will be used for ACTA statistical purposes. It is also used for incident reporting and the Leader’s observations. We, the riders named below, hereby waive, discharge and forever release any rights to claims for damage which we may have or which may accrue to us against the Auckland Cycle Touring Association, its officers, members, agents, and representatives. Rider’s Name Cell Phone Contact’s Name Phone Number & Contact’s Address & & 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17</p><p>Ride leader should make a note, on the back of the form, of any observations or incidents. Please tick the box if a note has been made. </p><p>Ride Leader please forward this form after the ride to: Chris Brooks, 1D/ 9 Furneaux Way, Remuera, Auckland 1050. Auckland Cycle Touring Association Ride Register & Emergency Contact Details 18</p><p>Ride leader should make a note, on the back of the form, of any observations or incidents. Please tick the box if a note has been made. </p><p>Ride Leader please forward this form after the ride to: Chris Brooks, 1D/ 9 Furneaux Way, Remuera, Auckland 1050. </p>