Team Entry Form

N$3 600.00 entry fee per team

Add Team Name:

Team Name

Personal Information for Rider One:

First Name

Surname

Date of Birth

ID Number

Gender:
Male Female

Contact Number

Email Address

Personal Information for Rider Two:

First Name

Surname

Date of Birth

ID Number

Gender:
Male Female

Contact Number

Email Address

Medical & Emergency Contact Information for Rider One:

Medical Aid Name

Medical Aid Number

Emergency Contact

Emergency Contact Number

Medical & Emergency Contact Information for Rider Two:

Medical Aid Name

Medical Aid Number

Emergency Contact

Emergency Contact Number

Indemnity:

(Please read carefully before submitting your entry.)

Read Indemnity Agreement

By submitting my entry, I confirm that I have read, understood, and accepted the terms of this indemnity agreement.

I agree

Please make sure you are signed in before submitting your entry!

ACCOMODATION PACKAGES

We have great accomodation packages, offered by the farm and lodge community.