REGISTRATION FORM
TALIBON CYCLING ADVENTURES, INC.
Talibon, Bohol
Website: www.talcycad.blogspot.com
TALCYCAD RACE
August 14, 2010
REGISTRATION FORM
Name: _____________________________________________________
Address: _____________________________________________________
Contact Info: Landline #: __________ Mobile
E-mail address: _______________________________
Date of Birth: (m/d/y) __________________ Place of Birth: ________________
Age : ______Sex: _________Height: __________ Weight: __________
Team/Club : ____________________________________________________
Occupation : ___________________________________ Full Time ( ) Part Time ( )
I hereby certify that the above information is true and correct:
______________________
Signature of Participant Over Printed Name
---------------------------------------------------------------------------------------------------
To be filled up by the committee:
Race Category: Road Bike - Open 
Mountain Bike _____Open Category ________ Junior Category
_____Senior Category _________Veterans Category
_____Executive Category
 |
Race Number :
Amount Paid: P ___________ Receipt No: ______________ Date: _________
0 comments:
Post a Comment