SPRING RIDE TO RHODES 2021

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Entry Form for Freedom Challenge - SRTR

First Name *

Surname *

ID NUMBER *

Age during ride *

Profession *

E-mail Address *

Mobile Number *

Daytime delivery address

For door-to-door courier deliveries (no PO Box please)

Street *

Town *

Postcode *

Race garment size? *

Would you like pre-printed maps and narratives delivered to your door at additional cost of R500? *

Yes

Please note:

- Download links to maps and narratives will be made available to all entrants
- Pre-printed maps and download links will be sent out on 15 Sep

Previously completed FC Events

If no previously completed FC events, please specify brief MTB experiences / races completed

Medical Aid - Name (if applicable)

Medical Aid - Number (if applicable)

Do you have any allergies?

Any pre-existing medical conditions?

Are you on any chronic medication?

Next of Kin Name *

Next of Kin Contact Number *

Race strategy (for batching purposes) *

Record attempt (must start in last batch)

Sub 15 days

16-18 days

19-21 days (must start before 18 October)

21 days plus (must start in 1st or 2nd batch)

not sure

Riding partner(s)

Preferred start day (see draft batches on website availability) *

Special dietary requirements (if applicable)

I have read the payment and withdrawal terms hereby accept them (Please check following box to confirm) *

Agree

Required

I have read the rider indemnity form and hereby accept it (Please check following box to confirm) *

Agree

Required

Other comments (you can insert any special invoicing details or promo codes here)

PLEASE READ:

- Once submitted, a thank you message will appear confirming entry submission
- You will receive invoice via email within 48 hours.
- You may pay in instalments of your choosing, please use same invoice number on all instalments.
- Deadline for all entry fee payments is 15 Sep 2021. Start batch place is only secured once entry is at least 30% paid.
-Ride info pack will be sent out on 15 Sep. This pack includes:
-Maps/narrative download links
-Ride preparation document
- Vehicle transfer booking form
- Family accommodation booking for start/finish

Submit

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