Mountain Biking Trails Eastern Cape

ONLINE ENTRY

Select an Event:

Team Name:

	Rider 1 (Primary Contact)	Rider 2
First Name(s):
Last Name:
ID Number:
Date of Birth:
Age at the end of this year:
Male or Female:

Cell:
Tel (w):
Tel (h):
E-mail Address:
Confirm E-mail Address:

Postal Address Line 1:
Postal Address Line 2:
Postal Address Line 3:

SACF Licence Number:

Medical Aid Name:
Medical Aid Number:
Medical Conditions to Note?:
Emergency Contact Name:
Emergency Contact Tel Number:

T-Shirt Size:

Payment Method:

	Disclaimer: By ticking this check box I declare that I (together with my legal guardian if I am under 18) am fully aware that Mountain biking is a dangerous sport and I agree that I will abide by the rules and participate at my own risk and confirm that I will have no claim whatsoever against the organisers, sponsors, local authorities or officials in respects of any injury or damage to persons or property arising out of any incident in any way related to this event.

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