MagDaCo 35th Anniversary Ride 2017

MagDaCo 35th Anniversary Ride to Ipoh

3-5 November 2017, Excelsior Hotel Ipoh

3D2N Single Occupancy @ S$200
3D2N Twin Share @ S$130 per pax

The registration fee is inclusive of 2 Event T-Shirts; 2 Breakfast; 1 Lunch & 1 Dinner at Rainbow Restaurant.

Closing dates: 2nd October 2017

* denotes mandatory fields.

APPLICANT

Name in Passport*

Alias / Nickname

Passport Origin*
SingaporeMalaysiaOther country

Passport No.*

NRIC No.*

Email* (a copy of this submission will go to this email.)

Address*

Telephone*

Gender*
FemaleMale

Halal meals*
YesNo

Date of Birth

Occupation

Bike Group
KRCIndividual riderOther bike club

Event T-shirt size (inclusive of pillion, if any.)
Size 34
Size 36
Size 38
Size 40
Size 42
Size 44
Size 46

 

PILLION RIDER / PASSENGER

Enter passenger's info

 

NEXT OF KIN

Name* (must not be a participant in this event.)

Relationship to applicant*

Telephone*

Address

Email

 

ACCOMMODATION / HOTEL ROOM

Hotel Room
If you are sharing room with another biker, only 1 person will make the FULL payment. The other biker will still need to register but skip payment. Please state the other biker's name and bike plate number in the Remark/Query box below.
3D2N Single Occupancy @ S$2003D2N Twin Share @ S$130 per pax3D2N Twin Share @ S$130 per pax. Please assign me a roommate.

Non-refundable Policy*
I agree and accept that when the hotel room is booked, I will NOT be able to get refund if I cannot attend the event.

 

PAYMENT MODES

You may use any of the transaction methods to make payment.
1. Bank account transaction to Tony Yeo (POSB Saving: 247-16820-6).
2. PayNow or PayLah transaction to Tony Yeo at 9220 0008.
3. Cash payment to Herbert Teh at Motor Sport Motor Sport Pte Ltd (Blk 3007, Ubi Road 1, #01-446, Singapore 408701)

Enter your bike number in your online bank transfer comment.

Attach a screenshot (not more than 3 MB) of your payment confirmation page.

Total Amount*
$200 for Single Occupancy$260 for Twin Share$130 for Twin Share. Assign me a roommate.

Bank Name

Transaction Reference No.

Date of Transaction

 

VEHICLE INFORMATION

Bike No.*

Brand

Model/year

Engine Capacity

Fuel Tank Capacity

Insurance Company

Insurance Policy No.

Insurance Expiry

 

REMARKS/QUERIES

 

How did you get to know about this event?

 

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.

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

I agree and accept the above mentioned terms.