Zondag / Dimanche / Sunday 13h – 17h

Wanneer?

zondag

namiddag

Omloop

niet-gevlakt

Inschrijven

Gegevens rijder / information pilote / rider information

Voornaam / Prénom / First name

Naam / Nom / Last name

Straat / Rue / Street

Huisnummer / Numéro / Number

Postcode / Code postal / Postal Code

Gemeente / Village / Village

E-mailadres

Tel.

Geboortedatum / date de naissance / date of birth

Andere gegevens

Nr op moto / Numéro sur le moto / Number on the bike

Cylinderinhoud / Cylindrée / Cylinder cc

Snelheidsindex
Hoe schat je op de schaal van 1 tot 10 uw eigen snelheid in? 1 = beginner, 10 = goede inter.
Comment évaluez-vous votre propre vitesse sur une échelle de 1 à 10? 1 = débutant, 10 = bon inter
How do you scale your speed from 1 to 10? 1= absolute beginner, 10 = fast inter

Groep

Begeleider(s) / Nom accompagnateur(s) / name of compagnon(s)

Ik ben akkoord met het privacybeleid / Je suis d’accord avec les gègles du confidiencialité / I agree the policy rules

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