BaltiCCycle Tours - BaltiCCycle

BaltiCCycle Tours

Year

Description / Program / Registration / Conditions

BaltiCCycle 2012

3^rd OLYMPIC BICYCLE EXPEDITION

FROM BEIJING TO LONDON
2012.02.27 - 2012.08.12

REGISTRATION FORM

Given names & surname

Citizenship

Personal code (if existing)

Passport data

Passport No.
Date of birth	(dd.mm.yy)
Place of birth
Date of issue	(dd.mm.yy)
Date of expiry	(dd.mm.yy)
Authority

Address

Street address
City
Postal code
Country

Telephones

E-mail

Chosen parts of the route / membership fee
(sign with mouse left-click button the country and type the number of days; the registration fee will be estimated automatically)

Country	Dates	Number of days	The chosen route		*Membership fee, €
Country	Dates	Number of days	Country	Number of days	20 €/day for 1-30 days 18 €/day for 31- 60 days 15 €/day for 61-168 days
China	02.27 - 03.15	18
South Korea	03.16 - 03.29	14
Japan**	03.30 - 04.24	26
United States	04.25 - 07.19	86
Ireland	07.20 - 07.26	7
Great Britain	07.27 - 08.12	17
TOTAL	02.27 - 08.12	168

* If a half of the participation fee is not paid until deadline (3 months before your start), the registration fee increases by 15% automatically. The second half of participation fee must be paid before your start date, otherwise it increases by 15% as well.

** Every day in Japan is additionally charged by 10 €.

Please enter the exact dates when you start and finish the ride. If you plan to join several times enter the dates for every part of the route.

Dates of start
Dates of finish

I would like to receive a discount (just one of below displayed)

	10% - student (until 26 years old)
	10% - long term traveller who cycled at least 100 days in the previous BaltiCCycle tours; if a cyclist reaches 100 days during the ride, the discount is counted from that day
	no discount
Data for discount

Note: The discounts are applicable for the first 60 days of cycling and only if the registration form and at least the half of participation fee is received not later than 3 months in advance before your start date.

TOTAL WITH DISCOUNT: 0 €

I would like to use the transportation service for my additional piece of luggage during the ride - 2 €/day (no more than 20 kg; one 25 kg standard bag is included in the registration fee)
Yes No

I will cycle in the tour 20 days or less but I would like to purchase BC2012 T-shirts - 10€ per unit (for participants who register for more than 20 days - free of charge)
Yes No

I would like to buy a safety jacket with BC logo - 3 € per unit
Yes No

FULL PAYMENT: 0 €

Your comments

I am familiar with the "Conditions of Participation" of the ride and agree with "Rules and Treaty for Participation and Responsibility"

In 5 days after the successful registration you will receive email confirmation with total amount of registration fee which must be paid to:

GMPR Lithuanian Fund,
AB SEB VILNIAUS BANKAS,
BIC=SWIFT: CBVI LT 2XXXX,
IBAN: LT83 7044 0600 0115 2710

I confirm that the information provided is correct

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