Individual Registration
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INDIVIDUAL REGISTRATION PARTICIPANT NAME:
MOBILE PHONE:
EMAIL:
AGE:
□ Male □ Female
Address: Hanoi Emergency Contact Person:
Mobile Phone:
Please ensure the person you have nominated as an emergency contact will be contactable throughout the day on this number
BICYCLE KOTO can arrange a bicycle for riders who do not have their own. Please note that we have access to a limited number of bikes, therefore if you are able to source your own that would be greatly appreciated.
□YES □NO ___cm (your height)
I will require KOTO to arrange a bicycle for me
We will be looking to donate our bikes to a local charity following the ride.
□YES □NO
RETURN TO HANOI (please indicate your return method of travel to Hanoi) □I wish to come back to Hanoi on Saturday on the Bus provided by KOTO and have my bike transported back to Hanoi and left at the training centre (101 Xuan Dieu St.) under supervision of KOTO staff. I agree not to hold KOTO responsible for any damage and loss of this bicycle and agree to collect my bike between 12noon and 4.00pm on Sunday 22nd November, unless otherwise negotiated.
□I will organise my own transport back to Hanoi □I want to ride back to Hanoi and understand that this will be without any support vehicles or personnel. HEALTH / FITNESS I declare that I am in good health and accept responsibility for my health and fitness during the ride. I also declare that I have appropriate travel / health insurance that covers me for cycling / adventure sports. I understand that my participation in the KOTO Ba Vi Bike Ride is voluntary and, whilst KOTO and the ride organisers take all reasonable care, I understand and agree that I will not hold KOTO or the ride organisers liable for any personal injury or damage to property.
SPONSORSHIP I agree to raise a minimum sponsorship fee nominated below to be paid to KOTO prior to the ride and any additional sponsorship money raised to be paid no later than 4th December 2009.
□US$150.00
□US$50.00 (for children under 12 years old)
SIGNATURE
DATE Please scan& return registration form by email to [email protected] or fax to: 84 -4 718 4580 no later than 9th November, 2009.
KOTO bike ride 2009 registration form
MOBILE PHONE:
EMAIL:
AGE:
□ Male □ Female
Address: Hanoi Emergency Contact Person:
Mobile Phone:
Please ensure the person you have nominated as an emergency contact will be contactable throughout the day on this number
BICYCLE KOTO can arrange a bicycle for riders who do not have their own. Please note that we have access to a limited number of bikes, therefore if you are able to source your own that would be greatly appreciated.
□YES □NO ___cm (your height)
I will require KOTO to arrange a bicycle for me
We will be looking to donate our bikes to a local charity following the ride.
□YES □NO
RETURN TO HANOI (please indicate your return method of travel to Hanoi) □I wish to come back to Hanoi on Saturday on the Bus provided by KOTO and have my bike transported back to Hanoi and left at the training centre (101 Xuan Dieu St.) under supervision of KOTO staff. I agree not to hold KOTO responsible for any damage and loss of this bicycle and agree to collect my bike between 12noon and 4.00pm on Sunday 22nd November, unless otherwise negotiated.
□I will organise my own transport back to Hanoi □I want to ride back to Hanoi and understand that this will be without any support vehicles or personnel. HEALTH / FITNESS I declare that I am in good health and accept responsibility for my health and fitness during the ride. I also declare that I have appropriate travel / health insurance that covers me for cycling / adventure sports. I understand that my participation in the KOTO Ba Vi Bike Ride is voluntary and, whilst KOTO and the ride organisers take all reasonable care, I understand and agree that I will not hold KOTO or the ride organisers liable for any personal injury or damage to property.
SPONSORSHIP I agree to raise a minimum sponsorship fee nominated below to be paid to KOTO prior to the ride and any additional sponsorship money raised to be paid no later than 4th December 2009.
□US$150.00
□US$50.00 (for children under 12 years old)
SIGNATURE
DATE Please scan& return registration form by email to [email protected] or fax to: 84 -4 718 4580 no later than 9th November, 2009.
KOTO bike ride 2009 registration form
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