Race Support Application for Oxford Back Protectors If this application is successful, it will form a binding contract between Oxford Products and the applicant. Please send this completed form, together with a copy of your ACU licence to:Oxford Products Ltd., De Havilland Way, Windrush Park, Witney, Oxon, OX29 0YA Name:
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Address:
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Telephone:
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Postcode:
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Mobile:
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Championship contended
………………………….. Date of first & last race
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ACU licence number:
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Size of back protector required
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The value of the back protector will need to be taken from a credit card in the form of a ‘race deposit’. This will be refunded at the end of the race season on production of your race results, together with a photograph of you with your bike and your back protector. This image may be used by Oxford Products Ltd. for marketing purposes free of charge or liability. Please deduct
£…………………………………
from my credit/debit card (postage free of charge)
Name of cardholder
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Issue number
Type of card
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(Mastercard, Visa, Maestro, Electron or Solo)
Card number
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Sec. (last 3 digits on back)
Date of Expiry
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Start date
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By signing below, you agree to wear the Oxford Back Protector for all race commitments, to wear an Oxford badge on your race leathers and an Oxford sticker on your bike. Thank you for joining the Oxford team! Signed: …………………………………… Printed: …………………………………...…
£79.99
£74.99
£69.99
£64.99
Date: …………….
£69.99