R2,500.00 – R12,500.00
This entry is for the solo category of the Tusker 2021 only.
If you are entering more than 1 person, please make sure to complete the relevant athlete details section before you add your entry to the cart.
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First Name: *
Last Name: *
Email: *
Mobile Number: *
Gender: * Male Female
Age: *
Date Of Birth (DD-MM-YYYY): *
ID Number: *
Emergency Contact Person: *
Emergency Contact Number: *
Allergies: *
Any medical conditions we should know about?: *
Medical Aid: *
Medical Aid Number: *
Family Doctor: *
Doctors Telephone Number: *
Do you use any performance enhancing medication?: * Yes No
Are you currently taking any medication (chronic or otherwise)?: * Yes No
Do you suffer from any of the following? (tick all that apply): Cardiovascular problems Respiratory problems Endocrine problems (diabetes) Musculoskeletal problems Central nervous system problems (fainting or epilepsy etc) Major illness within the last year Gastro intestinal problems Any family history of heart disorders
If you answered Yes to any of the above, please supply details:
If you have undergone any surgical procedures in the last 2 years, please supply details:
If you have ever suffered from a heart disorder or anaesthetic problem, please supply details:
What is your blood type?:
Race garment (top) size: * Ladies XS Ladies S Ladies M Ladies L Ladies XL Ladies XXL Mens XS Mens S Mens M Mens L Mens XL Mens XXL
Country: * ZA - South Africa AD - Andorra AE - United Arab Emirates AF - Afghanistan AG - Antigua and Barbuda AI - Anguilla AL - Albania AM - Armenia AN - Netherlands Antilles AO - Angola AQ - Antarctica AR - Argentina AS - American Samoa AT - Austria AU - Australia AW - Aruba AZ - Azerbaijan BA - Bosnia and Herzegovina BB - Barbados BD - Bangladesh BE - Belgium BF - Burkina Faso BG - Bulgaria BH - Bahrain BI - Burundi BJ - Benin BM - Bermuda BN - Brunei BO - Bolivia BR - Brazil BS - Bahamas BT - Bhutan BV - Bouvet Island BW - Botswana BY - Belarus BZ - Belize CA - Canada CC - Cocos [Keeling] Islands CD - Congo [DRC] CF - Central African Republic CG - Congo [Republic] CH - Switzerland CI - Côte d'Ivoire CK - Cook Islands CL - Chile CM - Cameroon CN - China CO - Colombia CR - Costa Rica CU - Cuba CV - Cape Verde CX - Christmas Island CY - Cyprus CZ - Czech Republic DE - Germany DJ - Djibouti DK - Denmark DM - Dominica DO - Dominican Republic DZ - Algeria EC - Ecuador EE - Estonia EG - Egypt EH - Western Sahara ER - Eritrea ES - Spain ET - Ethiopia FI - Finland FJ - Fiji FK - Falkland Islands [Islas Malvinas] FM - Micronesia FO - Faroe Islands FR - France GA - Gabon GB - United Kingdom GD - Grenada GE - Georgia GF - French Guiana GG - Guernsey GH - Ghana GI - Gibraltar GL - Greenland GM - Gambia GN - Guinea GP - Guadeloupe GQ - Equatorial Guinea GR - Greece GS - South Georgia and the South Sandwich Islands GT - Guatemala GU - Guam GW - Guinea-Bissau GY - Guyana GZ - Gaza Strip HK - Hong Kong HM - Heard Island and McDonald Islands HN - Honduras HR - Croatia HT - Haiti HU - Hungary ID - Indonesia IE - Ireland IL - Israel IM - Isle of Man IN - India IO - British Indian Ocean Territory IQ - Iraq IR - Iran IS - Iceland IT - Italy JE - Jersey JM - Jamaica JO - Jordan JP - Japan KE - Kenya KG - Kyrgyzstan KH - Cambodia KI - Kiribati KM - Comoros KN - Saint Kitts and Nevis KP - North Korea KR - South Korea KW - Kuwait KY - Cayman Islands KZ - Kazakhstan LA - Laos LB - Lebanon LC - Saint Lucia LI - Liechtenstein LK - Sri Lanka LR - Liberia LS - Lesotho LT - Lithuania LU - Luxembourg LV - Latvia LY - Libya MA - Morocco MC - Monaco MD - Moldova ME - Montenegro MG - Madagascar MH - Marshall Islands MK - Macedonia [FYROM] ML - Mali MM - Myanmar [Burma] MN - Mongolia MO - Macau MP - Northern Mariana Islands MQ - Martinique MR - Mauritania MS - Montserrat MT - Malta MU - Mauritius MV - Maldives MW - Malawi MX - Mexico MY - Malaysia MZ - Mozambique NA - Namibia NC - New Caledonia NE - Niger NF - Norfolk Island NG - Nigeria NI - Nicaragua NL - Netherlands NO - Norway NP - Nepal NR - Nauru NU - Niue NZ - New Zealand OM - Oman PA - Panama PE - Peru PF - French Polynesia PG - Papua New Guinea PH - Philippines PK - Pakistan PL - Poland PM - Saint Pierre and Miquelon PN - Pitcairn Islands PR - Puerto Rico PS - Palestinian Territories PT - Portugal PW - Palau PY - Paraguay QA - Qatar RE - Réunion RO - Romania RS - Serbia RU - Russia RW - Rwanda SA - Saudi Arabia SB - Solomon Islands SC - Seychelles SD - Sudan SE - Sweden SG - Singapore SH - Saint Helena SI - Slovenia SJ - Svalbard and Jan Mayen SK - Slovakia SL - Sierra Leone SM - San Marino SN - Senegal SO - Somalia SR - Suriname ST - São Tomé and Príncipe SV - El Salvador SY - Syria SZ - Swaziland TC - Turks and Caicos Islands TD - Chad TF - French Southern Territories TG - Togo TH - Thailand TJ - Tajikistan TK - Tokelau TL - Timor-Leste TM - Turkmenistan TN - Tunisia TO - Tonga TR - Turkey TT - Trinidad and Tobago TV - Tuvalu TW - Taiwan TZ - Tanzania UA - Ukraine UG - Uganda UM - U.S. Minor Outlying Islands US - United States UY - Uruguay UZ - Uzbekistan VA - Vatican City VC - Saint Vincent and the Grenadines VE - Venezuela VG - British Virgin Islands VI - U.S. Virgin Islands VN - Vietnam VU - Vanuatu WF - Wallis and Futuna WS - Samoa XK - Kosovo YE - Yemen YT - Mayotte ZM - Zambia ZW - Zimbabwe
Food preference: * Vegan Vegetarian I eat anything