{{Template.FormName}} Order Form

Order

Enter the quantity of each item to purchase

Item	Quantity	Price
{{item.Description}}	{{item.Quantity}}	{{ item.Price \| formatCurrency }}
Participant First Name Please provide the participant's first name. Participant Last Name Please provide the participant's last name. Age Please provide the participant's age.

{{item.Description}}		{{ item.Price \| formatCurrency }}
Total: {{Template.TotalAmount \| formatCurrency }}

Customer Information

Enter your information below

PAYMENT NOTICE to Proven card holders.
Please note, currently Cayman Water Co. Ltd is experiencing payment processing issues with Proven Bank cards via our online web portal. Until further notice, it is recommended that Proven card holders use an alternative credit card.

Full Name

Please provide a name.

Mailing Address

Please provide a stree address.

Apartment, suite, etc.

City

Please provide a city.

Postcode

Please provide a postal code.

Country

Please provide a country.

Phone Number

Please provide a phone number.

Email address

Please provide a valid email address.

I consent to allow my contact information to be used if we need to contact you about this order

I consent to receive emails about future events like this

Payment

Enter your payment info below

Full Name

Please provide the name on card.

Credit Card

Please select the card type

Please provide a valid credit card number

Expiration Date

Please provide a valid expiration month.

Please provide a valid expiration year.

Card Security Code

Please provide a card security code.

Billing Address

Enter billing address below

Same as mailing address

Billing Address

Please provide a billing street address.

Apartment, suite, etc.

City

Please provide a city.

Postcode

Please provide a postal code.

Country

Please provide a country.

Event Waiver

All Participants are deemed to take part at their own risk. The organisers shall be in no way responsible for the safety of the participant. By completing this entry form, all participants/ parents/ guardians accept the following:

Abide by the Cayman Islands Road Rules and Regulations. (Roads remain open to traffic).
Abide by the instructions provided by the event organisers and marshals.
Attest and verify that I have read, understood and I agree to the published race information made available by the Organisers.
Waive all possible rights that they or their dependents may have as a result of personal injury or death caused to them as a result of their participation in this event, and INDEMNIFY AND AGREE TO HOLD HARMLESS the organisers and sponsors from any liability whatsoever caused to any person or property as a result of their participation in the event.
Entry into the event can be made by cyclist aged 18 and over. For entrants aged under 18, entry must be made by responsible parents/guardians on behalf of the children in care.
Submission of properly completed registration, payment of entry fee and acceptance of race entry by the participant or his/her parent/ guardian is acknowledgement of the participant's/parent's/guardian's acceptance of full responsibility for his/her participation in the event.
I attest and verify that I am physically fit for the event.

I have read and agree to the terms of the waiver

Terms of the event waiver must be accepted to continue

Please correct the following error(s):

{{ error }}