Registration for :

MBS Cup 2009 - registration for season

  • Step 1 - Personal Info
  • Step 2 - Confirmation
  • Step 3 - Print
  • Step 4 - Payment

PERSONAL INFORMATION:

*Last Name:   *First Name:
*Street address:
*City:   *Province:
*Telephone:   *Email:
 
*Date of birth: (YYYY-MM-DD)   *Medical insurance number:
 
*In case of emergency(name):   *In case of emergency(telephone):
 
UCI code:   Club:

Category:

You must select one

Cost

$ 100

WAIVER

*I acknowledge that I have read the attached Waiver