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Senior Nationals Entry Form 2016

Please fill in the form below to ensure your place in the National Championships

Closing Date Midnight Sunday 21stĀ August


(Please note, fields marked with a * are required)

Your Name *
Club / Team *:

UCI code *:
License No*:
Your Email *
I would like to enter the following Events:-
Saturday 27th August

Women: 3k Pursuit Sprint 
Men: 4k Pursuit Sprint 

Sunday 28th August

Women: 500m TT Scratch 
Men: Kilo TT Scratch 

(Please provide times to help with the seeding)
* Note Track Accreditation Required *


To assist us in doing the initial 'seedings' and to verify eligibility for the event we need to know your certified 'Personal Best' times. The information you provide should be verifiable by a recognised authority:-

Personal Best 200 metres: Personal Best 500m Personal Best Pursuit: