Patagonman Xtri Application
The following information is necessary to enter the poll from where the participants will be selected
Email address *
First Name *
Your answer
Last Name *
Your answer
Gender *
Date of birth *
MM
/
DD
/
YYYY
Phone number (with country code) *
Your answer
Club, Team or Company you represent *
Your answer
Country *
Your answer
Name the longest triathlon you have ever done *
Your answer
Date when this was done *
MM
/
DD
/
YYYY
Time that it took you to finish the race *
Your answer
Any other reason why you should be selected to participate in Patagonman Xtri
Your answer
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