Menu
Home
About the Event
Registration
The Route
Entrance and Accommodation Packages
Cycle Village and Programme
Beneficiaries
Sponsors
Mechanical Backup
Useful Info
12 Week Training Recommendation
Packing List
Gallery
Contact
Latest News
Test form
Subscription Form
Δ
First Name
Last Name
Team Name:
Date of Birth:
Postal Address
Email Address:
Confirm Email Address
Your Preferred Name:
Cellphone number:
Telephone Number - Office:
Emergency Contact Number:
Emergency Contact Number 2:
Emergency Contact Name:
Emergency Contact Relationship:
Medical Aid/ Travel Insurance Number:
Primary Member
Medical Aid Plan
Chronic Condition Details:
Allergies:
Blood Group:
Dietary Requirements:
Passport Number:
Nationality:
Passport Date of Expiry:
Shirt Size:
Gender:
Male
Female
Do you grant permission for our beneficiaries to send you newsletters?
Yes
No
Do you have any formal wildlife experience/qualification?:
Yes
No
I have read and agree to the
Terms and Conditions
Register
Recent Comments
Suzanne Smith
on
Terms and Conditions
Mark
on
Terms and Conditions