24hr Cycle Challenge

24hr Cycle Challenge 2010

19-06-2010

Please note that it will take a few minutes to fill in these forms. Please do so carefully to ensure the correct information is entered.
It is also important to note that once you have chosen your wave and category you cannot change these.


registration	confirmation	payment	registration successful

Contact data:

Email:		Confirm email:
Contact number:

Address data:

Nationality:
Address:
Country:

Event data:

24hr Cycle Challenge 2010 - €75.00pp (excl booking fee of €3).

Race type:	road race mountain bike race
	Choose your category – please note once you have chosen your category and entered you cannot change it.
	* Must have a combined age of 200+

Team name:

How did you hear of this event?:

Personal data:

	First name / Surname	Email	Date of birth: (dd-mm-yyyy)	T-shirt size	Gender
Team captain:					male female
2.					male female
3.					male female
4.					male female
5.					male female
6.					male female
7.					male female
8.					male female
9.					male female
10.					male female

Terms and Agreements:

Before you can start in this event you must fill out this Medical Form. Please download the form, fill it out and bring it with you to event registration. All medical details are treated in the strictest confidence.

I have read and understood the terms and conditions waiver statement.

Yes I agree

Additional information:

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