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Registration form - Lithgow to Bathurst
We're excited that you're joining us - Its going to be a great weekend. Please complete the below form. Once complete, you will be sent an email with a link to pay or the ride online.
All cyclists must read and agree to the terms and conditions before riding:
https://katoke.com.au/katoke-cycle-terms-and-conditions/
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* Indicates required question
Email
*
Your email
Are you riding or joining the road crew?
*
Riding
Road crew
First Name
*
Your answer
Last Name
*
Your answer
Mobile phone number
*
Your answer
Address
*
Your answer
Date of birth
MM
/
DD
/
YYYY
Medicare number
Your answer
Do you have any ongoing Medical, Dietary, Allergy or other special needs that we should know about? Please list these requirements below. If none - please skip this question.
Your answer
Do you have any skills, talents or abilities which may be useful on the ride?
Mechanical
Medical
Other:
Clear selection
Name of emergency contact
*
Your answer
Emergency contact relationship
*
Your answer
Emergency contact phone number
*
Your answer
Would you be interested in riding an additional 50-100km on Saturday (Day 2 extension for advanced riders only)
Yes
No
Clear selection
IMPORTANT: I have read, understood and agree with all of the above Conditions, Risk Warnings and Waivers - please read them here:
https://katoke.com.au/katoke-cycle-terms-and-conditions/
. By selecting 'yes' below you agree to the above IMPORTANT statement.
*
Yes
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