Registration

kecill

Attention:

  1. Please read carefully Bali Audax Rule before submit at  http://baliaudax.com/bali-audax-rule/
  2. I have read the rules of Bali Audax  and accept them without reservation.
  3. Please Transfer Entry Fee and evidence of transfer at the same time you send the registration form
  4. You will get a confirmation email from the committee if you have completed the registration requirements

Hotel / Accomodations:  

Bali Audax 2018 will be use the hotel Aneka Lovinahttp://www.anekalovinabali.com/ and Grand Bali Beach Sanur http://www.grandinnabalibeach.com/

Registration Time: 

A.  Period  1 st  to 30 th May  2018  –  register time for  BALI AUDAX  Climbing  254 km

B.  Period  1 st  July  to 10 th  October 2018  –  register time for  BALI AUDAX  Classic 400 km.

PAYMENT of ENTRY FEE  including : 3 nights +  breakfast  / 2 times lunch / 2 times dinner/ airport transfer , free refreshments during cycling, medal finisher and 1 pc jersey.

Transfer Bank Indonesia

IDR. 3.500.000 (twin room)

and IDR. 4.200.000 ( single room)

Bank Central Asia (KCU Kuta)
Jl. Raya Kuta No. 55X Denpasar Bali 80361, Indonesia

Name : I Wayan Kertayasa
No. Rekening/Account number : 1 4 6 1 7 0 1 5 7 0
Swift Code : CENAIDJA

or

Transfer PAYPAL
Paypal Account : sport@balicycling.com
for paypal USD 280 (Share Room)  and USD 336 (Single Room) (*tax included)

IMG-20180522-WA0015

 

Title (required)

Your Name (required)

Transfer Entry Fee ID (required)

Your Email (required)

No. KTP / Pasport /Foreigner with Passport Copy(required)

Telephone(required)

Address

City

Zip Code

Nationality

Sex (required)

Date of birth (D/M/Y) (required)

Room (required)

Jersey Size (required)

Own Insurance by (not required)

Insurance No (not required)

Leave Us A Note

 

 

 

Please register for the cyclist advanced skill level only

 

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