Heini Championship'18 - TTT 2, 22nd July
Rider Information
1. Name of the rider *
Your answer
2. Rider date of birth *
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3. Blood group of the rider *
4. Gender *
5. Rider contact number *
Your answer
6. Email address *
Your answer
7. Emergency contact person name *
Your answer
8. Emergency contact person number (Should not be the same as Rider contact number) *
Your answer
9. Do you have any medical condition that the organizers should be aware of? Please specify.
Your answer
Registration Details
Registration Charges
• Payment Options - Online/Offline
- If registered for the series - INR 250/-
- If registering for individual event - INR 350/-
- Spot Registration for the individual event - INR 400/-
Payment Information
Bank Details
Account Type - Current 
Account Holder Name - Trysports
Account Number - 50200028267480
Bank Name - HDFC
Bank City - PALLADAM
IFSC Code - HDFC0002194
10. Payment Mode *
11. Transaction reference number *
Your answer
12. Transferred on *
MM
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DD
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YYYY
13. Transferred from Bank *
Your answer
14. I agree to sign the Accident Waiver and Release of Liability form at the bib collection counter. *
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