Registration Form RISE ABOVE BARRIERS FUN & SUPPORT WALK MAY 25, 2025
Last Registration day May 20, 2025
Let the FUN begin!
Your Name
*
Mr.
Mrs.
Miss.
Prefix
First Name
Last Name
Date of Birth
-
Dag
-
Maand
Jaar
Datum
Email Address
*
example@example.com
Contact Number
*
-
Area Code
Phone Number
Which route will you take?
5 KM - walk
5 KM - run
10 KM - walk
10 KM - run
Shirt Size
*
S
M
L
XL
XXL
XXXL
Registration fee
Selecteer
Early Bird Nafl. 30,-
2nd Time Participant with shirt Nafl. 15,-
2nd Time Particiipant no shirt Nafl. 25,-
FOR 2ND TIME PARTICPANTS PLEASE FILL IN YOUR CODE
If you received a coupon code please fill it in here
Would you like to be updated about all the good work Rise Above Barriers does with your contribution?
Yes
No
Payment
Please pay for your participation within 5 days by bank transfer stating your name to MCB bank account number:34493904 in name of Rise Above Barriers Foundation. We also have options to pay with Sentoo and cash. Within 24 hours after your payment you will receive a confirmation via email or whatsapp.
Submit
Should be Empty: