Emergency and Handicap Details for the Nearly World Championships Personal DetailsName* First Last Email* Nationality* AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Sex* Female Male Body Weight (kg)*We need this to calculate your handicap. Data will not be shared with others. We will be random weight dope testing the top finishers so make sure your weight is accurate. Height (cm)*We need this to calculate your BMI handicap. Data will not be shared with others. We will be random height dope testing the top finishers so make sure your height is accurate. No shrinking or growing till after the race. Date of Birth* MM slash DD slash YYYY How many kids do you have under 10?* Are you a single parent with kids under 18?*You deserve lots of bonus!! Yes No How shit is your bike ?*We will give you special bonus seconds if your bike is shit. Let us know which category best describes your bike. Race officials will be doing random bike checks at the race so no cheating. I have a Serk Bike. Automatic 3 minute bonus right? Not at all shit. My bike is pro level man. Completely shit. I shouldn’t really be racing on something like this. I heard there were bonus seconds up for grabs for shit bikes so I just had to enter this race. If I win it will be entirely thanks to the shitiness of my bike. Community High Five!* I donated some parts or cash to the Mongolian Womens team in 2017 I raised money for the koalas during Australian bushfires through the Serk Firecracker 400 in 2020 I donated some of the sale amount to Masaka Cycling Club when I sold something on the Second Hand Bike Sales Group I raised money for the Serk bikes that went to Masaka Cycling Club through the Firecracker 400 2021 I gave a tube to another rider on a Serk ride and didn't ask for it to be replaced I told someone that I could see their butt crack in the morning sun and suggested they buy some new Serk bibs Emergency Contact DetailsWe need this data in case of emergency. Passport Number*We need this to take out insurance for each rider. Person to contact in case of emergency*Immediate family / friend / housemate / workmate. Emergency Contact Person Phone Number*If you are visiting from overseas please include country code. Insurance CompanyIf you have this info it saves time during an emergency. Your Insurance Policy / Certificate Number EmailThis field is for validation purposes and should be left unchanged.