Online Entry Form
Event date: 24 to 26 May 2019
Venue: Zuurberg Mountain Inn, Eastern Cape

Preferential bookings for 2019 will be open for all packages –
platinum, gold, silver and bronze – and will be valid at the discounted rates below
until June 30.

Platinum, Gold & Silver entries for 2019 are sold out. Please contact tanya@mountainevents.co.za if you would like to go onto the waiting list in case of a cancellation.

Team Name *
Each team member must complete their own entry form - ensure that the same Team Name is entered on both forms
Your answer
Title *
First Name *
Your answer
Surname *
Your answer
ID Number *
Please enter your SA ID Number
Your answer
Email Address *
Your answer
Gender *
Date of Birth (dd-mm-yyyy) *
MM
/
DD
/
YYYY
Contact phone no. *
Your answer
Name of Medical Aid
Your answer
Medical Aid Number
Your answer
List any medical conditions you have
Your answer
Name of next of kin *
Your answer
Contact number for next of kin *
Your answer
Home Province *
Jacket / Shirt Size *
What is your MTB claim to fame (your most notable MTB achievement)?
Your answer
CSA membership no.
If you don't have a CSA membership then you will be required to pay the day license fee of R35 per day.
Your answer
If your preferred package is sold out and you would like to be added to the waiting list in case of a cancellation please email tanya@mountainevents.co.za
Please note: Your entry is only secured once paid. The preferential rates below are only valid until 30 June 2018
Choose your entry package - price is per rider *
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