Manfeild Criterium Series 2017 Registration
Bike Manawatu's Manfeild Criterium Series *November 2017* Proudly Sponsored by Bayleys
Email address *
First Name *
Your answer
Surname *
Your answer
Contact Phone *
Your answer
Existing Bike Manawatu Member *
Required
Date of Birth *
MM
/
DD
/
YYYY
Gender *
Emergency Contacts Name *
Your answer
Emergency Contacts Phone Number *
Your answer
Ride Category *
I wish to Register for: *
Would you like to register for a particular night OR the whole series
Required
Preferred Payment Method *
Bike Manawatu Members $5 p/night OR $15 for the series - NON members $10 p/night OR $35 for the series
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.
Required
Please leave other comments here
or email secretary@bikemanawatu.co.nz if you have any questions. Thank you
Your answer
Submit
Never submit passwords through Google Forms.
reCAPTCHA
This form was created inside of BikeManawatu. Report Abuse - Terms of Service - Additional Terms