Register for 2020 Rinjani 100

This page is SPECIAL PAGE. Please confirm with us first before you're submitting new registration. Not all submission from this page will be considered valid.
Take your time to fill in this registration form as accurate as possible. DNF the form is not an option!
Race Category
Click Here to view Category List and Fees

Race Experience

Tell us, at least one race that you have completed. For 117,7KM and 75KM, this will determine if you qualify to enter. Our Race Director will review your submission, and only after Approval (and Payment) your participation will be Confirmed.
Race Completed:
Detail:
Result:
or Upload your Result gif|jpg|png|jpeg|doc|docx|pdf (max filesize 5Mb)

Personal Information

First Name
Last Name
Nationality
Passport/KTP Number
Passport/KTP Upload
Upload your Passport/KTP gif|jpg|png|jpeg|doc|docx|pdf (max filesize 5Mb)
IMPORTANT: We need this to apply for National Park Permit
Date of Birth
format: example: 1985-12-01 for 1 December 1985
Gender
Blood Type
Event T-Shirt Size

Correspondence & Residential Address

Email
Same email can only be used for one runner
Mobile Number
Example: +6281212345678, +622198765432 Please include country code and area code (if applicable)
Address Street
City
State / Prov
Country
Postal Code
In case of emergency, who should we contact?
Emergency Contact Name
Emergency Contact Number
Example: +6281212345678, +622198765432 Please include country code and area code (if applicable)
Agreement
By registering for this event, you have read and agree to the conditions stated in the Terms and Condition, Rules & Regulations.
And you promise to train. HARD.

have problem with process registration? we can help you to register it manually by send your data with fields same as above to info@rinjani100.com