Cycling 4 CF Full Entry Form 2022

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Details to enter Ride Joburg 20 November 2022

SURNAME *

FIRST NAME *

CYCLING PACKAGES FOR 97km (If you are entering the 35km race please reduce all package amounts by R230) *

CYCLING SHIRT REQUIRED? *

CHOCE OF MEMENTO *

TYPE OF IDENTIFICATION *

ID NUMBER *

DATE OF BIRTH *

YYYY

GENDER *

PROVINCE *

COUNTRY OF RESIDENCE *

NICKNAME (max 8 characters)

EMAIL *

CELL NUMBER *

MEDICAL AID NAME *

MEDICAL AID NUMBER *

EMERGENCY CONTACT NAME *

EMERGENCY CONTACT CELL NO *

FACES TIMING BOARD REQUIRED - R80 each. This is compulsory for each cyclist as the RaceTec timing chip is no longer being used. If you entered in 2021, the Faces Timing Board issued as part of your race pack may be re-used. This year there is an extra charge for the timing chip, so if you need one you must add R80 to your package amount when you pay. *

YES

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