2023 REG FORM | Trans Tasmania

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2023 TRANS TAS - REGISTRATION

Full Name

Email

Country Code

Cell Number

Country

State/Province

Emergency Contact

Emerg contact cell number

Age as of Dec 31, 2023

Any Allergies? Food or medical? eg nuts, fish etc

Any Medical Conditions or Medication we need to know about?

FRIENDS LIST: LIST ALL FRIENDS YOU ARE PLANNING TO COME WITH (to make sure they get a spot as well and make sure I allocate you to the same room/accommodation with)

Couples: list husband/wifes/partners name here that are racing too, to make sure I allocate you to a private room with queen bed (they must also fill out their own reg form)

Package

All Inclusive (Single)

All Inclusive (Couple - eg coming wtih husband/wife/partner)

Self Support

Category

Open Men

Open Women

Master 40+ Men

Master 40+ Women

Old Boys 50+

E-Bike Women

E-Bike Men

Jersey Size

Mens Small

Mens Medium

Mens Large

Mens XL

Mens XXL

Womens Small

Womens Medium

Womens Large

Womens XL

Meal Requirements / Preference

Standard / Regular (no allergies)

Gluten Free

Vegetarian

Vegan

Lactose Intolerant

Other (comment in Allergy question above)

I agree to pay my reg to the below account

Bank Transfer Payment Account Details if needed:

Australian Domestic Transfer:

BSB: 084961

Account: 321789671

International Wire Transfer:

BSB: 084961

Account: 321789671

Name: Trans Tas

Address: 32-6 Charlston Place, Kuluin QLD 4558

BIC / Swift Code: NATAAU3303M

Full Payment:

All Inclusive $2,700

Self Support $1,299

Click Here

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