BaltiCCycle 2023

5th OLYMPIC EXPEDITION - Continuation
TO JAPAN

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:
30 €/day for 1–30 days
27 €/day for 31–51 days

Type the number of participation days, the registration fee will be estimated automatically.

Hokkaido: Wakkanai – Hakodate
1-28.07.2023, 28 days
days

Honshu: Hakodate – Tokyo
29.07-20.08.2023, 23 days
days

TOTAL: days
* If the registration and the half of participation fee are not received before December 31, 2022, the membership fee increases by 10%. If the second part of the fee is not paid before June 1, 2023, the membership fee increases by 10%.

TOTAL: €
 

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 discount10%privilege discount

10% – 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 the half of participation fee are received not later than before December 31, 2022.
** If a cyclist reaches 100 BC days during the ride, the discount is counted from the next day.

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 BC2023 T-shirts – 20 €/unit
(T-shirt 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 BC2023 T-shirts – 20 €/unit
(one you get free of charge)

Please enter the size of T-shirt

no t-shirtSMLXLXXL

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).

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

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