Tour de Bootlegger
Entry form for the Pure Savage Tour de Bootlegger happening in Cape Town

We will use this form to keep track of who is attending the ride and if we need to call anybody on the day.
Email address *
Name and surname *
Your answer
Cellphone number *
Your answer
Which stage would you like to take part in: *
Please pay the total of all the stages you wish to complete via EFT to the following details:

Name: Pure Savage
Acc number: 4092862052
Absa branch code: 632005
Type: cheque account

Please use the following reference: TDB+ your name

If you have already EFT'ed we will pick it up.
A copy of your responses will be emailed to the address you provided.
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