REGISTRATION IN THE WORLD CHAMPIONSHIPS 2006

(Each * field is compulsory.)

Personal Information
Title:*
Mr. Mrs. Miss

Last Name:
*

First Name:
*

Address:
*

Postal Code:
*

City:
*

Country:
*

Phone Number:

Email:

Bicycle model:

Bicycle brand:

Date of birth:*
Day: Month: Year:
I accept my age being published Yes No

 



Races Information I want to register as:


Class:*
Unfaired
Fully-faired
Multiple-person

Races:* (20 € each or 60 € for all races.)
Prologue (timetrial)
Hillclimb
Criterium
200 m sprint
1000 m sprint



Stay information

Date of arrival:*
  Day: Month: *

Number of staying days*:   

Number of family/friends coming with me*: among who will take part to the cycling tours.

Cycling tours (no fee) of length about:
no participation
30 to 60 km
60 to 80 km
80 to 120 km
120 to 180 km
and
Altiligerienne: fee to pay on site (10-20 €)

Accommodation:
Camping (3/5 € per night)
Hotel (39/45/50/54 € for 1 to 4 persons)
Youth hostel (10/12 € per night)(limited offer)
Bed and breakfast (45/55 € for 2 persons including breakfast)
Yourte tents (35 to 80 € for 2 to 6 persons)

House or bungalow (contact us)
Other

Dinner price : 9 € (Don't forget to include the dinners of your family/friends):
  Number of regular dinners:      
  Number of vegetarian dinners:  



Other information

I will come to Allegre by:

My speed records:

My best positions:

Other considerations: