Imvelo MTB Classic 2019 Entry Form
Please complete this this form fully to ensure accurate data capturing and results
Name *
Your answer
Surname *
Your answer
Gender *
Date of Birth *
ID Number *
Your answer
Country of Residence *
Telephone Number
Your answer
Cellphone Number
Your answer
Email Address *
Your answer
Medical Aid
Your answer
Membership Number
Your answer
Main Member
Your answer
PLEASE NOTE: Only children under the age of 12 are eligible for prizes in the 12.5km Hoglet. The youngest category in the 64km Classic is Junior so all participants under the age of 18 will compete in this category.
Please tick appropriate box
Hoglet 12.5km R220.00
Family 22km R255.00
Challenge 35km R370.00
Classic +/-65km R440.00
Hoglets <12
Sub Junior 12 - 14
Youth 15 -16
Junior 17 - 19
Senior 19 - 29
Sub Vet 30 - 39
Vet 40 - 49
Master 50 - 59
Grand Master 60+
T-Shirt Size *
PLEASE NOTE: Race Shirt goodie bags will only be given to Classic Marathon participants. If you entered the Marathon and downgrade to the Half Marathon Challenge you will forfeit the Race Shirt for a T-Shirt.
Please Note: Should you not be in possession of a VALID CAS / CSA license, you will be required to buy a day license at registration from the Cycling Association of Swaziland
Cycling License Number
Your answer
I, hereby declare that I am 18 years or older or that I am the parent / legal guardian of the aforementioned minor, I also declare on behalf of myself / minor in my charge, that I: Assume all risk of participation in the IMVELO MTB CLASSIC; Absolve and discharge the organisers, officials, marshalls, helpers, sponsors or any local authority or employee of the afore- mentioned parties from all claims for loss, damage, injury or death, howsoever caused, arising from participation in the IMVELO MTB CLASSIC; Agree to abide by all rules and regulations of the race and of Mlilwane Wildlife Sanctuary. *
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service