Registration form
Rider details:
Name: *
Your answer
IC No/Passport: *
Your answer
Date of birth: *
MM
/
DD
/
YYYY
Gender: *
Email: *
Your answer
Tel/Hp:
Your answer
Country: *
Your answer
Emergency contact details:
Name: *
Your answer
Contact no: *
Your answer
Relationship: *
Your answer
Race classes:
Registration fee BND$55 (Payment can be made at the opening dinner by cash in Brunei dollars) *
Jersey:
Size: *
For participant under 18 years old:
Parents/Guardian's name:
Your answer
Parents/Guardian's IC:
Your answer
Parents/Guardian's contact no:
Your answer
Submit
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