Manfeild Criterium Series 2017 Registration
Bike Manawatu's Manfeild Criterium Series *November 2017* Proudly Sponsored by Bayleys
Existing Bike Manawatu Member
Date of Birth
Emergency Contacts Name
Emergency Contacts Phone Number
I wish to Register for:
Would you like to register for a particular night OR the whole series
Tuesday 7th November 2017 ($5 members / $10 non members)
Tuesday 14th November 2017 ($5 members / $10 non members)
Tuesday 21st November 2017 ($5 members / $10 non members)
Tuesday 28th November 2017 ($5 members / $10 non members)
The Full Series ($15 members / $35 non members)
Preferred Payment Method
Bike Manawatu Members $5 p/night OR $15 for the series - NON members $10 p/night OR $35 for the series
Online Bank Transfer - Bike Manawatu - ANZ Bank - 01-0745-00284925-000 REF Your Name & Nov Crit 17
Cash (on the day) Please bring correct cash
Eftpos (on the day)
Do you Accept the following terms
In registering for Bike Manawatu's Manfeild Criterium Series held on Tuesday 7th November, Tuesday 14th November, Tuesday 21st November & Tuesday 28th November, I hereby acknowledge the risk and hazards involved while participating in such events and activities and do so at my own risk.
Please leave other comments here
if you have any questions. Thank you
Send me a copy of my responses.
Never submit passwords through Google Forms.
This form was created inside of BikeManawatu.
Terms of Service