PGV Gravity - Registration form

* Required question  
First Name *
Last Name
Gender
Date of birth *
 

Identification Number *


KTP SIM (Indonesian ID)
PASSPORT (International ID)

T-Shirt Size *
Email Address *
Personal Phone Number *
Emergency Contact Person No *
Emergency Person Name *
Relationship with Emergency name*
Blood Type * O
A
B
AB
Rh+
Rh-
Category *

Junior (Age 16-19)
Men Pro (Age Open)
Men Open (Age 20-29)
Men Master Expert (Age 30 - Up)
Men Master A (Age 30-34)
Men Master B (Age 35-39)
Men Master C (Age 40-49)
Veteran (Age 50 - Up)
Women Open (Age Open)

Club/Team Name
Sponsor
Race Event *
Disclaimer Participants should be aware that mountain biking is an inherently dangerous activity. Each participant is responsible for his/her own safety. Each Participant who lose transponder Must Pay 1,3jt (IDR), By submitting this form, participants agree that race officials cannot be sued for any injury or loss of life that may happen during the race. It is the right of the race officials to cancel the race in case of uncontrollable events such as natural disaster, riot, war, etc. RIDE SAFE.

Yes, I agree
*