BERG 100 ENTRY (only 19 years and older may ride)
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First Name
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Last Name
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Email
Gender
Male
Female
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ID number or DOB (dd/mm/yyyyy) - no under 19s allowed
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Phone Number
Province
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Medical Aid Name
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Medical Aid Number
Allergies/ Medical conditions?
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Emergency contact name
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Emergency contact number
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Category (Bike Type)
MTB
Gravel Bike
E-Bike
How many Berg 100 races have you done to date?
0
1
2
3
4
5
6
7
8
9
Did you ride Highland 100 in 2019?
T-Shirt Size?
S
M
L
XL
XXL
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Please confirm you agree to CSA and Berg 100's Rules and Indemnity
Yes
SUBMIT
Berg 100 2021
Mar 27, 2021, 7:00 AM
Nottingham Road
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Safire Berg 100