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Xtrem/Loue 2024
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Randonnée VTT Xclusive 55 - 65km
Name
First name
Gender
Male
Female
Nationality
Afghan
Albanian
Algerian
American
Andorran
Angolan
Antiguans
Argentinean
Armenian
Australian
Austrian
Azerbaijani
Bahamian
Bahraini
Bangladeshi
Barbadian
Belarusian
Belgian
Belizean
Beninese
Bhutanese
Bolivian
Bosnian
Botswana
Brazilian
British
Bruneian
Bulgarian
Burkinabe
Burundian
Cambodian
Cameroonian
Canadian
Cape Verdean
Central African
Chadian
Chilean
Chinese
Chinese Taiwanese
Colombian
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Congolese
Costa Rican
Croatian
Cuban
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Danish
Djibouti
Dominican
Dutch
Ecuadorean
Egyptian
Emirati
English
Equatorial Guinean
Eritrean
Estonian
Ethiopian
Fijian
Filipino
Finnish
French
Gabonese
Gambian
Georgian
German
Ghanaian
Greek
Grenadian
Guatemalan
Guinea-Bissauan
Guinean
Guyanese
Haitian
Honduran
Hong Kong
Hungarian
Icelander
Indian
Indonesian
Iranian
Iraqi
Irish
Israeli
Italian
Ivorian
Jamaican
Japanese
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Kazakhstani
Kenyan
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Laotian
Latvian
Lebanese
Lesothan
Liberian
Libyan
Liechtensteiner
Lithuanian
Luxembourger
Macao
Macedonian
Malagasy
Malawian
Malaysian
Maldivian
Malian
Maltese
Marshallese
Mauritanian
Mauritian
Mexican
Micronesian
Moldovan
Monacan
Mongolian
Montenegrin
Moroccan
Mozambican
Myanmar
Namibian
Nauruan
Nepalese
New Zealander
Nicaraguan
Nigerian
Nigerien
North Korea
Northern Irish
Norwegian
Omani
Pakistani
Palau
Palestinian
Panamanian
Papua New Guinean
Paraguayan
Peruvian
Polish
Portuguese
Qatari
Republic of Korea
Romanian
Russian
Rwandan
Salvadoran
Samoan
San Marinese
Sao Tomean
Saudi
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Serbian
Seychellois
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Singaporean
Slovakian
Slovenian
Solomon Islander
Somali
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Spanish
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St Lucian
Sudanese
Surinamer
Swazi
Swedish
Swiss
Syrian
Tajik
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Thai
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Trinidadian or Tobagonian
Tunisian
Turkish
Turkmen
Tuvaluan
Ugandan
Ukrainian
Uruguayan
Uzbekistani
Venezuelan
Vietnamese
Welsh
Yemenite
Zambian
Zimbabwéen
Date of birth
Accompanying person's name and surnae
Address line 1
Postal code
City
Phone Number
FR (+33)
BE (+32)
DE (+49)
ES (+34)
IE (+353)
MC (+377)
CH (+41)
IT (+39)
AU (+61)
ID (+62)
PT (+351)
AT (+43)
BR (+55)
US / CA (+1)
DK (+45)
FI (+358)
GR (+30)
MA (+212)
NL (+31)
GB (+44)
SE (+46)
ZA (+27)
CZ (+420)
LU (+352)
IN (+91)
RO (+40)
NO (+47)
CG (+242)
JP (+81)
PL (+48)
NC (+687)
MG (+261)
ZW (+263)
RW (+250)
AL (+355)
DZ (+213)
AR (+54)
BJ (+229)
BY (+375)
KH (+855)
CM (+237)
CV (+238)
CL (+56)
HR (+385)
EE (+372)
EG (+20)
MF (+590)
MQ (+596)
GY (+594)
RE / YT (+262)
HT (+509)
HU (+36)
IR (+98)
IL (+972)
LV (+371)
LB (+961)
MK (+389)
ML (+223)
MU (+230)
MX (+52)
ME (+382)
NE (+227)
NZ (+64)
SN (+221)
RS (+381)
SG (+65)
SK (+421)
LK (+94)
TG (+228)
TN (+216)
TR (+90)
TD (+235)
VE (+58)
RU (+7)
CN (+86)
PK (+92)
JO (+962)
PE (+51)
CU (+53)
CO (+57)
MY (+60)
PH (+63)
TH (+66)
KP (+82)
VN (+84)
AF (+93)
MY (+95)
SD (+211)
LY (+218)
GM (+220)
MR (+222)
GN (+224)
CI (+225)
BF (+226)
LR (+231)
SL (+232)
GH (+233)
NG (+234)
CF (+236)
ST (+239)
GQ (+240)
GA (+241)
CG (+243)
AO (+244)
GW (+245)
IO (+246)
IA (+247)
SC (+248)
SD (+249)
UA (+380)
ET (+251)
KE (+254)
SO (+252)
DJ (+253)
TZ (+255)
UG (+256)
BI (+257)
MZ (+258)
ZM (+260)
NA (+264)
MW (+265)
LS (+266)
BW (+267)
SZ (+268)
KM (+269)
SH (+290)
ER (+291)
AW (+297)
FO (+298)
GL (+299)
GI (+350)
IS (+354)
MT (+356)
CY (+357)
BG (+359)
LT (+370)
MD (+373)
AM (+374)
AD (+376)
SM (+378)
VA (+379)
BA (+387)
SI (+386)
LI (+423)
FK (+500)
BZ (+501)
GT (+502)
SV (+503)
HN (+504)
NI (+505)
CR (+506)
PA (+507)
PM (+508)
BO (+591)
GY (+592)
EC (+593)
PY (+595)
SR (+597)
UY (+598)
CW (+599)
TL (+670)
CC (+672)
BN (+673)
NR (+674)
PG (+675)
TO (+676)
SB (+677)
VU (+678)
FJ (+679)
PW (+680)
WF (+681)
CK (+682)
NU (+683)
WS (+685)
KI (+686)
TV (+688)
PF (+689)
TK (+690)
FM (+691)
MH (+692)
KR (+850)
HK (+852)
MO (+853)
LA (+856)
BD (+880)
TW (+886)
MV (+960)
SY (+963)
IQ (+964)
KW (+965)
SA (+966)
YE (+967)
OM (+968)
PS (+970)
AE (+971)
BH (+973)
QA (+974)
BT (+975)
MN (+976)
NP (+977)
TJ (+992)
TM (+993)
AZ (+994)
GE (+995)
KG (+996)
UZ (+998)
BS (+1242)
BB (+1246)
AI (+1264)
AG (+1268)
VG (+1284)
VI (+1340)
KY (+1345)
BM (+1441)
GD (+1473)
TC (+1649)
MS (+1664)
MP (+1670)
GU (+1671)
AS (+1684)
SX (+1721)
GLC (+1758)
DM (+1767)
VC (+1784)
TT (+1868)
JM (+1876)
E-mail
Are you UCI's licensed ?
non
oui
UCI license's number
Option accident insurance
option accident insurance [+ 4 €]
Rep'Omelette (saturday night since 19:30)
Unit price 12€
(Minimum 0 - Maximum 10)
Option Tandem
No
Yes [+ 12 €]
I agree to abide by the rules put in place by the organization.
Yes
