Register for 2018 Mesastila Peaks Challenge

Take your time to fill in this registration form as accurate as possible.

Race Experience

Tell us, at least one race that you have completed. For 100KM, 65KM and 42KM, this will determine if you qualify to enter. Our Race Director will review your submission, and only after Approval (and Payment) your participation will be Confirmed.

There is no qualification needed to enter 11KM and 21KM, but if you have completed any race before, we'd love to know!
Race Completed (1):
Detail:
Result:
Race Completed (2):
Detail:
Result:

Files Upload

Headshot
Foto 1/2 Badan
Upload your photo here, showing your face clearly. (Format: jpg|jpeg|png)
Passport/KTP Upload
Upload Passport/KTP (Format: pdf|jpg|jpeg|png|gif)
IMPORTANT: We need this to apply for National Park Permit
KITAS Upload
Only for KITAS Holder (Format: pdf|jpg|jpeg|png|gif)
Race Result (1)
This is optional. Screenshot or e-certificate of your previous race result.
(Format: pdf|jpg|jpeg|png|gif)
Race Result (2)
This is optional. Screenshot or e-certificate of your previous race result.
(Format: pdf|jpg|jpeg|png|gif)

Personal Information

First Name
Last Name
Nationality
Passport/KTP Number
Are you KITAS holder?
YESNO
KITAS Number
 
Date of Birth
format: example: 1985-12-01 for 1 December 1985
Gender
Blood Type
Event T-Shirt Size

Unisex Size Chart

Correspondence & Residential Address

Email
Same email can only be used for one runner
Mobile Number
Example: +6281212345678, +622198765432 Please include country code and area code (if applicable)
Address Line 1
Address Line 2
City
State / Prov
Country
Postal Code
Emergency Contact Name
In case of emergency, who should we contact?
Emergency Contact Number
Example: +6281212345678, +622198765432 Please include country code and area code (if applicable)
Agreement
IMPORTANT: This is a very challenging trail race. By registering for this event, you have read and agree to the conditions stated in the Terms and Condition, Rules & Regulations.
And you promise to train. HARD.
Fee in IDR Rp. 0.00
Fee in USD $0.00
After your registration is submitted, you will be redirected to Payment Page to choose your payment method.