Desert Challenge - Round 3 – 424 Off Road Racing Championship Series

RACE REGISTRATION

424 Cross Country Championship Series

Select Event *

Select Class *

First Name *

Surname *

Date of Birth *

ID / Passport Number *

Email Address *

Mobile Number *

Province / City *

Preferred Race Number *

Team / Club Name

Bike Make *

Bike Model *

Bike Year *

Engine Capacity (cc) *

Engine Type *

Emergency Contact Name *

Relationship *

Emergency Mobile *

Alternative Contact

Medical Aid Provider *

Medical Aid Number *

Blood Type

Allergies *

Existing Medical Conditions *