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Category 5 Fitness - Cycling Community Registration

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Category 5 Fitness - Cycling Community Registration Form

Welcome to the Category 5 Fitness Cycling Community! Please fill in your details to help us know you better and ensure your safety during events.

Personal Details

Full Name *

Date of Birth *

Email *

Phone Number *

Address *

Health & Emergency Information

Blood Group *

Medical Conditions *

Hypertension (High Blood Pressure)

Upper Respiratory Tract Infections

Back and Neck Pain

Diabetes

Arthritis

High Cholesterol

Anxiety

Digestive Issues

Stroke

Cardiovascular Disease

Other (Please specify below)

None

Emergency Contact Name *

Emergency Contact Number *

Cycling Experience

Cycling Level *

Beginner

Intermediate

Advanced

Do you have your own cycle or need assistance?

Yes, I have my own cycle

No, I need assistance

Declaration

I hereby declare that the information provided above is true to the best of my knowledge. I take full responsibility for my participation in the running community activities.*

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CATEGORY5 FITNESS

423,Thadagam road, R.S Puram, Coimbatore, Tamilnadu - 641002

category5fitnessind@gmail.com
+91-9092226707
+91-9087776707

PLEASE FEEL FREE TO SEND US AN E-MAIL AT category5fitnessind@gmail.com FOR ANY ADDITIONAL INQUIRIES

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