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Online Registration 2019
Event: Pumping Legs For Water
Date: 25th – 27th July 2019
Address: Hwange National Park
Email address *
Personal
Date Of Birth
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Age if under 18
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Full Name *
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Gender
Address
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Residency
Mobile Number
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Medical Information
Doctors Name
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Contact Number
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Medical Aid Details & Number
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Contact Person
Person to contact in case of an emergency
Name
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Contact Number
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General
Ride Shirt Size: Short Sleeve
Ride Shirt Size: Long Sleeve
Average Speed Off Road
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Name of Last Ride and Date
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Ride Distance
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Time You Completed Last Ride
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Are you able to assist in getting bikes back from Ngweshla and do you have a seconder
Rules and Conditions
To participate in this ride cyclist must: a) Complete & submit this registration form, b) Pay an entry fee of USD $200, c) Seek additional sponsorship and d) Receive confirmation of participation from the Ride Secretary. Entry fees should be deposited into the WEZ bank account: Wildlife & Environment Zimbabwe, Barclays Bank Main St. Branch Acc. No. - 2307-2223098 Sort Code - 2322 Swift Code - BARCZWHX Closing date for entries is 31 May 2019. 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 $200. 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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