Great Southern Brevet 2021 Registration Form
Welcome to the sixth edition of the Great Southern Brevet to be held from the 23rd of January to the 30 of January 2021.

The form below is to register your details for the event. There is no cost to register. This information is required for safety and a requirement for crossing private property along the route. Please note that access across private land is for the event and entry to the event does not imply access at any other time. Please respect landowners rights.

Please complete your details below and submit as soon as possible so you will have one less thing to worry about as you prepare for your ride.

Thanks for your registration and look forward to seeing you on the shores of Lake Tekapo on the 23rd of January, 2021 for what should be another great adventure.

PLEASE only complete this form if you are reasonably certain you are coming. It will be used to arrange equipment hire, so if you have only a passing interest at this stage then visit the website (greatsouthernbrevet.blogspot.com) for information.
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Trying to forget 2020, then start 2021 with a breath of fresh air! We have plenty of it in the high country!
Rider Details
Please complete your details below.
First Name/Given Name *
Last Name/Surname *
Nickname
Street Address *
Suburb
City *
Country *
Date of Birth *
Day/Month/Year
Your email address *
Your Mobile Number
This should be the number you will be using during the ride for your Txt Check ins. We need this to identify you have reached the Checkpoints.

We may also Txt you if there are any changes to the course once riding is underway.
Your Mobile Number - please include your country prefix if not a New Zealand mobile *
Example: +61 2345 6789.    Put 0 in the box if you don't know your NZ mobile number yet. Once you have you number please email it to greatsouthernbrevet@gmail.com.
SPOT Tracker
A SPOT Tracker provides a means for you to contact assistance in the case of an emergency. A SPOT Tracker must be carried (see Rule 5). If you do not have a SPOT Tracker, they are available to hire. The link will be on the GSB website soon.

Please remember to RETURN the unit at the end of the ride before you leave Tekapo!
Do you need to hire a SPOT Tracker? *
I will be using my own SPOT Tracker
If you are using your own SPOT Tracker please provide the following details to allow it to be tracked.
What is your SPOT Tracker ESN
This is the 8 digit number inside the battery cover X-XXXXXXX
What is the URL (web address) for your SPOT Tracker shared page?
This is needed to link to LIVE tracking. Please ensure your page is shared Public.
Emergency Contact Details
These are the people we will contact if you request help via your SPOT Tracker HELP button. They will also be contacted if you request Emergency assistance (SOS button on your SPOT Tracker). Your primary contact should be someone capable of responding to your request for help or can arrange an appropriate response.
Emergency Contact Name *
This person must not be a rider in the event
Emergency Contact Phone Landline Telephone Number *
Please include country prefix if not a New Zealand number. Example: +61 2345 6789
Emergency Contact Mobile Number *
Please include country prefix if not a New Zealand number. Example: +61 2345 6789
Emergency Contact Email address *
Details on the website *
We will publish a list of riders registered so you can confirm your entry. Your first and last name and location only will be  displayed. If you do not wish to display your name please tick the box below. The Great Southern Brevet does not share your details with any other organisation and respects your privacy.
Required
Indemnity
I, the undersigned, hereby acknowledge that the ride organisers, and the owners of the land used for this ride, accept no liability for any loss, damage or injury to ourselves resulting from our participation in this ride. We participate in this ride at our own risk and acknowledge that there may be risks associated with the sport of cycling. I have read and understand safety and other information drawn to my attention by the organiser and agree to abide by safety requirements set out by the organisers and agree to abide by the rules which appear on the website. A parent or guardian must sign the indemnity form on behalf of a rider under the age of 18  
I have read and accepted the Indemnity for the Great Southern Brevet 2021 *
Required
Final Details
Please do not push submit until you have completed all relevant sections of the registration form.

Further information about the event can be found at www.greatsouthernbrevet.blogspot.com. There is plenty of helpful information and tips about the ride on the website. You can also keep up to date by visiting us on Facebook at facebook.com/greatsouthernbrevet.

Any questions please contact us on greatsouthernbrevet@gmail.com
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