Individual Registration

Please enter information in the form below to process registration for event Kapps Mountain Venue Xtrail.

Existing user? Please login

New User? Please register

Username*

Password*

Retype password*

First Name *

Last Name *

Xtrail Distance *

6km

14km

6km Kids (14 and U)

Email *

Gender *

Female

Male

Current Age *

Medical Aid Details

Policy Number *

Policy Name *

Emergency Contact Name *

Emergency Contact Number *

Indemnity

MAJOR INDEMNITY: I hereby indemnify sponsors, organisers, local and other authorities of any loss or injury, however that loss or injury may be caused which might occur in preparation for, during or subsequent to the event, in any circumstance in which sponsors, organisers, local and other authorities might attract a legal liability in respect of such injury or loss.

MINOR INDEMNITY: I the Parent/ Guardian, of the minor entered into the event, hereby indemnifies sponsors, organisers and local and other authorities of any loss or injury, however that loss or injury may be caused which might occur in preparation for, during or subsequent to the event, in any circumstance in which sponsors, organisers, local and other authorities might attract a legal liability in respect of such injury or loss.

Select *

major(over 21 years of age)

minor (under 21 years of age)

Payment Information

Amount

Payment Method

Offline Payment