Personal Details:

Race Details:

If No, please fill your License Number in below.

With regards to my participation in this event

I agree to participate at my own risk, I agree that I shall have no claim whatsoever against the organizers, officials, marshals, helpers, sponsor organizations, the Cycling Association of Swaziland (cas) or any local authority for any loss, damage or injuries whatsoever that I may suffer as a result of my participation in this event. That includes our arrival and departure there from, and any ceremonies as a result of this function. I also accept responsibility for my own health insurance in the event of my submitting this form. I am bound by the above waiver including to the extent to which he/she is not capable of waiving his/her rights stipulated above.

Upon submission of this form I agree to the above waiver
Banking Details: FNB • Account Name: Cycling Association of Swaziland Account No.: 62284942614 • Branch Name: Mbabane, Swaziland • Branch Code: 280164 • Ref: Name & Race

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