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Registration Form
*
Indicates required field
Team leader
*
First
Last
Cell phone No
*
ID No:
*
Email
*
Gender
*
Male only
Female female only
mixed team
rider 1
*
Rider 2
*
Rider 3
*
Rider 4
*
Emergency contact
*
Team Name
*
Waiver
We agree that No liability whatsoever shall be attached to the organizers, promoting club, sponsor, or any official or member of the promoting club in respect of any injury, loss or damage suffered by me or by reason of the race, however so caused
*
Yes
PAYMENT DETAILS
To complete your registration you can Deposit entry fees to the following account:
Cycle for Life Club
Bank: Stanbic Bank Botswana
Branch: Fairgrounds
Account No: 9060002018387
Please send proof of payment to tjmmoloke@yahoo.com and use your Name as reference
REFUNDS will be assessed on a case by case basis. NO REFUNDS if you register and don't pitch up on race day
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