Drake Events – Events Planner, Event Services. Gauteng area: Johannesburg, Pretoria | Entry Form

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Menu

Home
Services
Events
Request a Quote
Testimonials
Gallery
Contact Us
About
- About Us
- Join the Team

Home
Services
Events
Request a Quote
Testimonials
Gallery
Contact Us
About
- About Us
- Join the Team

Outride Registration Form

Please read the Terms and Conditions, as well as the Rules, then complete the registration form below

Terms & Conditions

Personal Information

Name *
Surname *
Date of Birth *
ID/Passport Number *
Gender *

Contact Details

Cell No *
Whatsapp No *
Email *

Address Details

Country *
Address *
Suburb *
City *
Postal Code *

Emergency Contact

Your emergency contact should not be participating but must be traceable in the event of an emergency
Name & Surname *
Contact Number *
Relationship to Entrant *

Alternative Emergency Contact

Name & Surname *
Contact Number *
Relationship to Entrant *

Medical Aid Information

Medical Aid Name
Membership No
Membership Plan
Main Member Name

Personal Health

Please be as honest as possible in order for you to receive the correct medical attention
Current Medication
Allergies

Entry Information

Route Selection *
160km Freedom Day MTB Ride
Group Selection MTB *
Entry Type *
Solo Entry (R350)
Please state any food allergies *
Do you want to order an official Drake Events cycling jersey, manufactured by Van H?
(Not sure of your size? Check the sizing guide) - Sizing guide is the following link - https://vanh.co.za/pages/sizingYesNo
What size cycling jersey do you want to order?
Do you want to order socks?
YesNo
What size sox do you want to order?
Do you require a bike wash at the finish venue?
YesNo

NB Documents

Please confirm *
I have read and agree to the Terms and ConditionsI have read and agree to the Rules

Verification

Please enter any two digitsExample: 12
This box is for spam protection - please leave it blank

Contact Details

Organiser

Wesley Drake – 072 076 9245
Xanné Drake – 082 370 8614

Price

Banking Details

Drake Events
Bank: FNB
Branch : 230732
Account Number : 62854277110

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