3 NRC Ride 2016

3 NRC Ride 2016
2nd – 4th September 4
Hua Hin, Thailand

* denotes mandatory fields.

APPLICANT

Name*

NRIC/Passport No.*

Email*

Address*

Telephone*

Gender*
FemaleMale

Date of Birth

Occupation

Bike Group
KRCOther bike club

Event T-shirt size
Size 36 , Size 38
Size 40 , Size 42
Size 44 , Size 46

 

BANK TRANSACTION DETAILS

Please transfer the exact amount to Tony (POSB Saving: 247-16820-6).

Bank Name

Transaction Reference No.

Amount
SGD

Date of Transaction

 

NEXT OF KIN

Name*

Relationship to applicant*

Contact*

Address

Email

 

ACCOMMODATION / HOTEL ROOM

Room
SingleTwin ShareTriple ShareQuart Share

 

PILLION RIDER / PASSENGERS

Enter passenger's info

 

VEHICLE INFORMATION

Make

Model/year

Engine Capacity

Fuel tank Capacity

Bike Reg. No.*

Insurance Company

Insurance Policy No.

Insurance Expiry

Your Message

DECLARATION & INDEMNITY

By submitting this form, I declare that the information provided above is true to the best of my knowledge. I further declare that I have willing participated in this event/ride voluntarily. I do hereby fully indemnify all persons, officials, organizers and agents of the event/ride. In the event of an accident, I will not have any claims whatsoever against any party whether the accident is a result of my mistake or through a second party or third party. I pledge that I will cooperate fully with the organizers and their appointed marshals. I will adhere to the rules of participation and accord due consideration and courtesy to all fellow participants and motorists. Further, I also abide by the rules and regulations pertaining to the traffic regulations and laws in the respective countries that I will be transiting or visiting.

I agree and accept the above mentioned terms.

To avoid "phantom" registrants, your registration will only be confirmed after the organiser has confirmed your payment.