Sign Up
First Name
Last Name
Address line 1
Address line 2
City
State/Province/Region
Postal Code
Country
-- Select Country --
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua And Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas The
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Cook Islands
Costa Rica
Cote D'Ivoire (Ivory Coast)
Croatia (Hrvatska)
Cuba
Cyprus
Czech Republic
Democratic Republic Of The Con
Denmark
Djibouti
Dominica
Dominican Republic
East Timor
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
External Territories of Austra
Falkland Islands
Faroe Islands
Fiji Islands
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia The
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey and Alderney
Guinea
Guinea-Bissau
Guyana
Haiti
Heard and McDonald Islands
Honduras
Hong Kong S.A.R.
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea North
Korea South
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau S.A.R.
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Man (Isle of)
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands Antilles
Netherlands The
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestinian Territory Occupied
Panama
Papua new Guinea
Paraguay
Peru
Philippines
Pitcairn Island
Poland
Portugal
Puerto Rico
Qatar
Republic Of The Congo
Reunion
Romania
Russia
Rwanda
Saint Helena
Saint Kitts And Nevis
Saint Lucia
Saint Pierre and Miquelon
Saint Vincent And The Grenadin
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Smaller Territories of the UK
Solomon Islands
Somalia
South Africa
South Georgia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard And Jan Mayen Islands
Swaziland
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Togo
Tokelau
Tonga
Trinidad And Tobago
Tunisia
Turkey
Turkmenistan
Turks And Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
United States Minor Outlying I
Uruguay
Uzbekistan
Vanuatu
Vatican City State (Holy See)
Venezuela
Vietnam
Virgin Islands (British)
Virgin Islands (US)
Wallis And Futuna Islands
Western Sahara
Yemen
Yugoslavia
Zambia
Zimbabwe
ID Number
Age
Cellphone Number
Email
Invoice Details
Invoice Name
VAT Number
Address line 1
Address line 2
City
State/Province/Region
Postal Code
Country
-- Select Country --
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua And Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas The
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Cook Islands
Costa Rica
Cote D'Ivoire (Ivory Coast)
Croatia (Hrvatska)
Cuba
Cyprus
Czech Republic
Democratic Republic Of The Con
Denmark
Djibouti
Dominica
Dominican Republic
East Timor
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
External Territories of Austra
Falkland Islands
Faroe Islands
Fiji Islands
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia The
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey and Alderney
Guinea
Guinea-Bissau
Guyana
Haiti
Heard and McDonald Islands
Honduras
Hong Kong S.A.R.
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea North
Korea South
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau S.A.R.
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Man (Isle of)
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands Antilles
Netherlands The
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestinian Territory Occupied
Panama
Papua new Guinea
Paraguay
Peru
Philippines
Pitcairn Island
Poland
Portugal
Puerto Rico
Qatar
Republic Of The Congo
Reunion
Romania
Russia
Rwanda
Saint Helena
Saint Kitts And Nevis
Saint Lucia
Saint Pierre and Miquelon
Saint Vincent And The Grenadin
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Smaller Territories of the UK
Solomon Islands
Somalia
South Africa
South Georgia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard And Jan Mayen Islands
Swaziland
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Togo
Tokelau
Tonga
Trinidad And Tobago
Tunisia
Turkey
Turkmenistan
Turks And Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
United States Minor Outlying I
Uruguay
Uzbekistan
Vanuatu
Vatican City State (Holy See)
Venezuela
Vietnam
Virgin Islands (British)
Virgin Islands (US)
Wallis And Futuna Islands
Western Sahara
Yemen
Yugoslavia
Zambia
Zimbabwe
Next of Kin
Contact Name
Contact Number
Relationship (wife, Father etc)
Medical Details
Current Medication
Allergies
Medical Aid Name
Medical Aid Number
Principle Member
Rally Info
KTM Model
Skill Level
Please Select Skill Level
Beginner
Intermediate
Advance
Route
Please Select Route
Green
Red
Orange
Mens T-Shirt Size
Please Select Mens T-Shirt Size
S
M
L
XL
XXL
3 XL
4 XL
5 XL
Ladies T-Shirt Size
Please Select Ladies T-Shirt Size
XS
S
M
L
XL
XXL
3 XL
4 XL
5 XL
KTM Advanture Bike Rally 2019
Accommodation
Tented Sharing Option - R 4,690.00 incl. VAT
PLEASE NOTE: ALL ROOMS ARE SOLD OUT, ONLY TENTED OPTIONS ARE STILL AVAILABLE
I want to share a room with
A Rally Rider
A non-Rider
Do not want to share
Name Of Non-Rider
Non-Rider Contact Number
Non-Rider Email Address
Non-Rider Medical Aid
Gender of Non-Rider
Male
Female
Name Of Rider
Rider Contact Number
Rider Email Address
Rider Medical Aid
Gender of Rider
Male
Female
Referring Dealer
Dealership
Please Select..
Alfie Cox Racing
Auto Motorcycles
KTM Cape Town
KTM Durban
Fast KTM
KTM Nelspruit
Motos Klerksdorp
Orange County KTM
Raceworx KTM
RAD Moto KTM
The Roost KTM
Trax KTM
Centurion KTM
Wildcoast KTM
Ultimate Race
Did you enter the Ultimate Race?
Please Select..
Yes
No
KTM Portal
Username
Password
Confirm Password *
Profile Picture
.jpg .png .jpeg .gif file allowed, max Upload Size 2mb
Captcha
14 - 16 =
Total Payable Amount @
Sign Up