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Online Registration 2020
Event: Pumping Legs For Water
Date: 3rd – 6th September 2020
Closing Date: 30th July 2020
Address: Hwange National Park
Email address *
Date of Birth
MM
/
DD
/
YYYY
Age if under 18
Full Name *
Gender
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Address
Residency
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Mobile Number
Medical Information
Doctors Name
Contact Number
Medical Aid Details & Number
Contact Person
Person to contact in case of an emergency
Contact Name
Contact Number
General
Ride Shirt Size: Short Sleeve
Ride Shirt Size: Long Sleeve
T-Shirt Size
Average Speed Off Road
Name of Last Ride and Date
Ride Distance
Are you able to assist in getting bikes back from Ngweshla and do you have a seconder
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Rules and Conditions
To participate in this ride cyclist must: a) Complete & submit this registration form, b) Pay an entry fee of USD $120, c) Seek additional sponsorship and d) Receive confirmation of participation from the Ride Secretary. Entry fees should be deposited into the WEZ bank account:
Bank Account Details:
Barclays Bank of Zimbabwe, Main Street Branch (Now known as First Capital Bank Limited)
Account Name: Wildlife and Environment Zim – Matabeleland Branch.
Branch: Main Street, Bulawayo
Branch Code: 2307 (007 if doing internet trf).
FCA Account no: 23072223098 (If paying by local RTGS/bond deposit).
External Nostro Account no: 23071249190 (If paying in forex from sources outside Zimbabwe).
Domestic Nostro Account no: 23073569486 (If paying in forex from sources within Zimbabwe)
Closing date for entries is 30 July 2020. Numbers may have to be limited. See Rules & Conditions for further details. This is NOT A RACE. The ride is open to individuals and teams of 2 people, however relay teams may only change over at designated points. Each member of a relay team will be required to submit an entry form & pay the entry fee of USD $120. Riders under the age of 10 will not be accepted. Children under the age of 16 must ride with a parent. You will be riding in a wildlife area, all rules must be strictly adhered to. Helmets must be worn.

I acknowledge that I have read and accepted the rules and conditions set out for this event. I accept that while the organisers will make every effort to ensure that the event is safe and enjoyable I am participating entirely at my own risk - neither the individuals involved in organising the event, Wildlife & Environment Zimbabwe, Zimbabwe Parks & Wildlife Management Authority, sponsors nor their employees may be held responsible for any injury or loss of life, or for any loss or damage to my person or property.
I Have Read & Agree To The Rules & Conditions *
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A copy of your responses will be emailed to the address you provided.
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