Registration form


BaltiCCycle 2019

„Mysterious and Misty Scotland”
July 4-30, 2019

 

Personal data

Given names & surname

Citizenship

Personal code (if existing)

Date of birth

Place of birth

Passport data

Passport No.

Date of issue

Date of expiry

Authority

Address data

Street address

City

Postal code

Country

Telephones

E-mail

Membership fee, 25 EUR/day

(type the chosen number of days, and the registration fee will be estimated automatically)

07.04-07.30:
days

Please, enter exact dates when you start and finish the ride:

(If you plan to join 2 times, enter the dates for every part of the route).
Date of start 1

Date of finish 1

Date of start 2

Date of finish 2

THE MEMBERSHIP FEE: euro

I would like to receive a discount*

(just one of below displayed)

15% – long term travellers who cycled in the previous BaltiCCycle tours (2003-2019) 100 days and more; if a cyclist reaches 100 days during this ride, the discount is counted from that day;;

10% – students (not more than 26 years old), families (3 and more persons);

special – participants who obtain potential sponsors or support organizers before or during the expedition in another way (preparing the route, driving the support car, medical or bicycle service, etc.) will receive a privilege discount negotiated personally;

* NOTE: The discounts are applicable only if the registration and a half of the membership fee are received by the close of the business day on June 4, 2019. The second part of the fee must be paid 5 days before your start, otherwise the whole fee will increases by 10%.
Participants who do not have any discount, must pay the fee at least 20 days before their start date; otherwise the fee increases by 10% as well.

I would like to use the transportation service for my additional piece of luggage (up 20 kg) – 2 EUR / day.
(the transportation of one standard bag is included in the registration fee)

I would like to purchase an additional BC2019 T-shirt – 15 EUR / unit.
(one T-shirt is free of charge for participants cycling more than 10 days)

TOTAL PAYMENT: euro

Your comments:

I am familiar with the "Conditions of Participation" of the ride and agree with "Rules of Responsibility".

In 5 days after sending the Registration Form you will receive the Registration Confirmation Letter.

CROTOS Travellers’ Association
6-57, Sobieskiego St.
02-957 Warsaw
Poland

ING Bank Śląski
The Corporation Branch II
45, Malczewskiego St.
02-622 Warsaw
Poland
nr PL77105010411000002305516409
nr BIC (SWIFT): INGBPLPW

ALL BANK REMITTANCE CHARGES MUST BE PAID BY PARTICIPANT.

I confirm that the information provided is correct.

I hereby agree to the processing of my personal data for the registration purposes in accordance to the Personal Data Protection Act from 10 May, 2018 (Journal of Laws 2018, item 1000).