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Xtrem/Loue 2024
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Randonnée VTT Découverte 16km
Name
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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
