Home Events Entries Results Contacts
RevitaPro Klipriviersberg December Challenge
Entries Close 8th December 2017, late entries will be taken on the day but will incur a R20 penalty. Please complete the entry form below for each athlete. Payment must be made via EFT or direct deposit to: C Peternell Standard Bank Acc no. 062818384 Branch Code 006005

*indicates required fields 
  *Name:
  *Surname:
  *Distance:  4-5 Km @ R60
 10Km @ R120
 18km @ R150
  *Age:
  *Sex:  Male
 Female
  ID Number:
  *Category:  Junior u18yrs
 Open 18-40
 Senior 40+
 Vet 60+ 30% discount on 10km and 18km
  *Cell Number:
  *Emergency Contact Name:
  *Emergency Contact Number:
  *Email Address:

If doing multiple entries, one payment for the total amount can be made and proof of payment with list of names can be emailed to entries@southerntrails.co.za
Home
Events
Entries
Results
Contacts
  
Site Map