Registration form


BaltiCCycle 2021

5th OLYMPIC EXPEDITION /Continuation/
FROM THE IGUAZÚ FALLS TO TOKYO
2021.03.27–07.24

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

Issued by

Contact data

Street address

City

Postal code

Country

Telephones

E-mail

Chosen parts of the route / membership fee

Membership fee:
25 €/day for 1–30 days
22 €/day for 31–60 days
18 €/day for 61–106 days
30 €/day for Hawaii

Type the number of participation days; the registration fee will be estimated automatically:

Iguazú Falls – Salta
27.03-26.04, 31 days
days

Salta – Santiago de Chile
27.04-25.05, 29 days
days

Hawaii***
27.05-06.06, 11 days
days

Wakkanai – Hakodate
09.06-05.07, 27 days
days

Hakodate – Tokyo
06.07-24.07, 19 days
days

TOTAL: days exception Hawaii and in Hawaii.

* If the registration and a half of the participation fee is not received until February 27, 2021 for the route in South America, and April 27, 2021 for the route in Hawaii and Japan, the membership fee increases by 10%. The second half of participation fee must be paid 10 days before your start date; otherwise it increases by 10% as well.

** The membership fee in Hawaii is 30 €/day. No discounts for that part of the route will apply.

*** The dates of transferring from South America to Hawaii as well as from Hawaii to Japan are not included when counting days.

FEE:

 

Please enter the exact dates when you start and finish the ride.


(If you plan to join several 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


I would like to receive a discount*:

(just one of displayed below; no discounts for the Hawaii part of the route)

15% – for the first 60 days for students (until 26 years old), families (3 and more persons traveling together) and BC veterans who cycled more than 100 days in the previous BC tours**

a privilege discount – negotiated personally for participants who obtain potential sponsors or support organizers before or during expedition in another way (preparing day descriptions, finding sleeping places, servicing bicycles, medical support, etc.).

Data for discount (describe):

* Discounts are applicable if the registration and at least the half of participation fee is received not later than February 27, 2021 for the route in South America, and April 27, 2021 for the route in Hawaii and Japan.

** If a cyclist reaches 100 BC days during the first 60 days of his/her participation, the discount is counted from this date for the remaining days up the 60th day. No discounts for the next days, because the membership fee reduces significantly.

TOTAL WITH DISCOUNT:



I would like to use the transportation service for my additional piece of luggage – 2 €/day
(no more than 15 kg; 25 kg luggage is included in the registration fee)

I will cycle 20 days or less but I would like to purchase BC2020/BC2021 T-shirts – 15 €/unit
(for participants who register for more than 20 days – free of charge)

I will cycle more than 20 days but I would like to purchase additional BC2020/BC2021 T-shirts – 15 €/unit
(one you get free of charge)

Please enter the size of T-shirt

no t-shirtSMLXLXXL


EMERGENCY FUND* (days x 2€)
(Unspent money from the Emergency Fund will be returned in 30 days after the ride in the proportion of amount of your contribution.)









FULL PAYMENT:

Your comments:

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

In 5 days after the successful registration you will receive email confirmation with total amount of registration fee which must be paid to:

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 28 August, 1997 (Journal of Laws No 101, item 926).

If after clicking "Send" you will see such statement "There was a problem with your registration form. Please try again later.", click one more time "Send".