Package €*
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Bike Hire
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Category*
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Team Name*
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Personal Details Rider 1
Passport No.*
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Date of Birth*
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Gender*
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First Name*
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Surname*
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Your Email*
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Region*
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Please specify nationality*
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Cellphone*
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T-shirt Size*
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International Medical and Emergency Information Rider 1
International insurance is required and arranged together with your flight details.
Policy/Medical Aid Name*
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Policy/Medical Aid Number*
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Emergency Contact Name*
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Emergency Contact No.*
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Personal Details Rider 2
Passport No.*
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Date of Birth*
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Gender*
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First Name*
Please fill in your name.
Surname*
Please fill in your surname
Your Email*
Please fill in your email address.
Region*
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Please specify nationality*
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Cellphone*
Please fill in your contact number
T-shirt Size*
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International Medical and Emergency Information Rider 2
International insurance is required and arranged together with your flight details.
Policy/Medical Aid Name*
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Policy/Medical Aid Number*
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Emergency Contact Name*
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Emergency Contact No.*
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Entry
Total: €
0.00
Where did you hear about the 4 islands MTB race?*
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Other: Please specify*
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How many stage races do you ride per year?*
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