Bike for Elephants

Registration form 2011

Would you like to join? Register as soon as possible! The registration fee is 2,500 baht (excluding a bike) or 3,300 baht (including a bike), and you will find sponsors for the event for a minimum amount of 5,000 baht. Please transfer your registration fee asap to:

Account number: 505-2-36520-6 (Siam City Bank – Chang Klan branch) of Bring the Elephant Home in Chiang Mai. Please send us the bank slip by email.

Or tranfer online for Bike for Elephants.

The minimal amount you should raise is 5.000 Baht (100 euro) per person. Please use this form to register.

Fields with * are required. ‘E-mail address’ - ‘Phone number’: information is meant for Bring the Elephant Home and will not be published on the website. ‘Name team’ - ‘Website team (e.g Facebook)’: information will be published on our website. You can ask people to join your team, your e-mail address then wil be published. Thank you very much for joining Bike for Elephants! Please read the waiver.

E-mail address *
First name *
Middle Initial
Surname *
Sex	Male Female
Organisation
Street *
House number *
Addition to house number
State, Zip code
Place of residence *
Country *
Phone number *
Name team *
Names of other members of your team *
City
Country *
Presentation of your team in 100 words max. *
Ask people on the website to join your team? *	No Yes
Target amount to raise (in Baht)
Name company/organization
Website team (e.g Facebook)
	I agree with the terms and conditions (see above)

* Field required.

Registration form 2011

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