SIKLISTA CLUB PERSONAL DATASHEET

First Name *

Last Name *

Birthdate *

Gender * Male Female

Nickname *

Nationality *

Blood Type * =Please indicate your blood type= A+ A- B+ B- AB+ AB- O+ O- I don't Know

Allergies *

Phone number *

Email Address *

Complete Address *

In case of Emergency *

Phone Number of Contact person *

Complete Address of Contact Person *

Please upload 1x1 photo for your ID *

Password

I consent to the collection and processing of my personal information by Go for Gold Siklista Club in accordance with the Data Privacy Policy provided. I understand that my information will be used for club-related purposes as outlined in the policy. *

Confirm

**After clicking the confirm button. Please wait for the checkout button and proceed with shipping details. Kindly put same name for the shipping details**