Registration

Needed information

Name of the Super Randonnée

Last Name

First Name

Date of Birth

Mailing Address (where the documents will be sent)

Email

Club Affiliation (or « no license »)

Club Name (or « independant rider »)

Option: Randonneur or Touriste

if Randonneur, please indicate your date and starting time

By registering for the Super Randonnée, the participant declares on his / her honor that he / she is in sufficient physical condition to complete the course chosen, and to have read the safety instructions.

By registering for the Super Randonnée, the participant declares on his / her honor that he / she has read the following information:

Participants are strongly advised to take out individual accident insurance extended for cycling (unless they have a sports license including such insurance).

Provence Randonneurs has no individual accident insurance for participants. Provence Randonneurs did not take out insurance for the repatriation of the participants. Provence Randonneurs is insured in civil liability, in accordance with Article L321-1 of the French Sports Code.

Registration can be done by email to: mattersophie@gmail.com

Payment

The registration fee is 5 euros.

Payment via PayPal: send 5,50 euros at mattersophie@gmail.com

Bank transfer: please contact us for the bank details

Money orders or checks (only if drawn from a French bank) must be payable to Provence Randonneurs, and sent to :

Sophie Matter

3960 ancien chemin de Salernes

83570 Cotignac

FRANCE