The Siemens Action Asia Himalayan Mountain Bike
3-day stage event - NEPAL 2002

Event Organizers: Himalayan Mountain Bike

Opening Ceremony: Thamel 22nd (Friday)November
Races dates: 23rd / 24th / 25th November
Awards Night: 25th Nov (evening) Radisson Hotel

Individual Entry:
Name:_________________________
Nationality:_________________________

Entry me in:
The Series  or  Race  1  2  3
Sex: M/ F
Date of Birth (d/m/y) :______________
Phone: (w)_____________ (mob/h)_____________
Fax:________________
Email:______________________
Address:____________________
T-shirt size: (s/ m/ L/ XL)
Past Medical History/Known Allergies:_________________
Blood type:_________

Signature:                        Date:

In case of emergency during the event, please contact:
Mr./Mrs
Tel:______________

Please fax/email/speed-post applications to: Attention:
Race Director - Peter Stewart ----- Himalayan Mountain Bikes (P) Ltd. PO Box 12673, Kathmandu, NEPAL Tel / Fax: (+977-1) 4442345 or 413590

Or

Please fax/email/speed-post applications to:
Action Asia - Attention - SAAHMB
19 Fl, Winsome House, 73 Wyndam St, Central, Hong Kong
Tel (852) 2165 2800 Fax (852) 2868 1799

FOR MORE INFORMATION GO TO: www.bikeasia.info or info@bikeasia.com or www.actionasia.com

School's
(Please note that each school team must consist of three members)

School Team Name:___________________
School Extra Curricular Activities teacher:__________________
Name:__________________
Fax:____________________
Email:______________________
Address:_____________________

Team Captain*:_____________________
Sex: M/ F
Date of Birth (d/m/y):_________________
Phone: (h)__________________ (school)_____________
T-shirt size: (s/ m/L/ XL)
Past Medical History/Known Allergies:___________________
Blood type:___________________

Signature:                      Date:

In case of emergency during the event, please contact:_________________
Mr./Mrs:___________________
Tel:________________

Member 2:__________________
Sex: M/ F
Date of Birth (d/m/y):__________________
T-shirt size: (s/ m/ L/ XL)

Past Medical History/Known Allergies:___________________________
Blood type:_____________________

Signature:                        Date:

In case of emergency during the event, please contact:_________________
Mr./Mrs:___________________
Tel:________________

Member 3:__________________
Sex: M/ F
Date of Birth (d/m/y):__________________
T-shirt size: (s/ m/ L/ XL)

Past Medical History/Known Allergies:___________________________
Blood type:_____________________

Signature:                        Date:

In case of emergency during the event, please contact:_________________
Mr./Mrs:___________________
Tel:________________

www.bikingnepal.com