KOTO Dream Ride 2017 online registration form

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* NOTE: If you are A GROUP (MORE THAN 5) from the same company/organisation, please send us an email to honghanh.bui@gmail.com, we will send you another form for corporate registration.

KOTO is a unique not-for-profit social enterprise that brings hope to at-risk and disadvantaged youth in Vietnam. We provides 24 month free of charge internationally accredited hospitality training program, English for hospitality and Life-skill.

KOTO BIKE RIDE is an annual fundraising ride; all proceeds will be used to support the work of empowering youth through holistic training program with free accommodation and care.

For more details, please contact us at honghanh.bui@koto.com.au – (+84) 975319654

PARTICIPANT NAME *

Gender

Male

Female

Clear selection

Age *

Company

Email *

Mobile *

Address

Hanoi Emergency Contact Person *

Please ensure the person you have nominated as an emergency contact will be contactable throughout the day. Please let us know how to contact them (mobile, etc)

Require KOTO to arrange a bicycle ?

KOTO can lend riders a bicycle at 220,000/bike if they do not have their own. Please note that we have access to a limited number of bikes, therefore if you are able to source your own that would be greatly appreciated.

Yes

Clear selection

Height (in cms) if bike required

We provide free pick up and drop off from Ciputra (inTay Ho) for riders and their bikes, please let us know if you want to use this service *

For me only

For my bike only

For me and my bike

No, I do not want to use this service

Your t-shirt size *

XXL

HEALTH / FITNESS *

I declare that I am in good health and accept responsibility for my health and fitness during the ride

I also declare that I have appropriate travel / health insurance that covers me for cycling / adventure sports

I understand that my participation in the KOTO Bike Ride is voluntary and, whilst KOTO and the ride organisers take all reasonable care, I understand and agree that I will not hold KOTO or the ride organisers liable for any personal injury or damage to property.

Required

Payment *

Payment can be made using one of the methods listed below. Details will be provided in the confirmation email sent to you after you submit this application.

Bank transfer via ANZ Hanoi – Vietnam

Bank transfer via Techcombank Hanoi

Pay in Cash at KOTO restaurant 59 Van Mieu, Dong Da, Hanoi ( Monday - Friday, 9 am. - 6 p.m)

(Not available) Pay in Cash at Chula Fashion 43 Nhat Chieu, Tay Ho ( Saturday and Sunday, 9 a.m - 6 p.m)

We come to collect ( for groups only)

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