1. I hereby declare that I am aware of no reason why I should not be granted the requested licence.
I undertake to spontaneously return my licence in the event of any substantial change to the circumstances existing at the time of the application for a licence.
I declare that I have not applied for a licence for the same year to the UCI or to any other national federation.
I assume exclusive liability for this application and for the use that I shall make of the licence.
2. I hereby undertake to respect the constitution and regulations of the Union Cycliste Internationale, its continental confederations and its national federations.
I declare that I have read or have had the opportunity to become acquainted with the aforesaid constitution and regulations.
I acknowledge and agree that my personal information provided as part of my application shall be passed and held by the UCI.
I shall participate in cycling competitions or events in a sporting and fair manner.
I shall submit to disciplinary measures taken against me and shall take any appeals and litigation before the authorities provided for in the regulations. I accept the Court of Arbitration for Sport (CAS) as the sole competent body for appeals in such cases and under the conditions set out in the regulations.
I accept that the CAS shall be the court of last instance and that its decisions shall be definitive and without right of appeal. With those reservations, I shall submit any litigation with the UCI solely to the courts within whose jurisdiction the head offices of the UCI lie.
3. I agree to submit to and be bound by the UCI antidoping regulations, the clauses of the World Antidoping Code and its international Standards to which the UCI antidoping regulations refer and to the antidoping regulations of other competent bodies as per the regulations of the UCI and the World Antidoping Code provided that they comply with that Code.
I agree that the results of the analysis may be made public and communicated in detail to my club or team or to my paramedical assistant or doctor.
I agree that all urine samples taken shall become the property of the UCI which may have them analyzed, especially for purposes of health protection research and information.
I agree that my doctor or the doctor of my club or team may, on a request from the UCI, communicate to it a list of any medicines I may take and treatment I may undergo before any given competition.
4. I accept the conditions regarding blood testing and accept to undergo blood tests.