Registration Form

Name

Last Name

Email

Date of birth (yyyy-mm-dd)

Palce of birth

Address

ZIP

City

Country

Sex
 M F

Mobile number (to wear during the race)

Phone number in case of emergency

Racing licence number

Bike choice (Brand and Model)

Notes

In the absence of racing card, you must attach a copy of medical certificate for non-competitive

Attach Rules Book signed (downloadable from the website in the "Rules")