Personal InformationNew Record - Input Form

＊Please input all the blanks with alphabets.
For those who do not live near Karatsu City and need to stay overnight , please apply for lodging request.
Overnight stay will be charged.

Fields with * are required.

Name:
(First Name) (Middle Name) (Family Name)
Gender:
Country/Region:
E-mail address:
E-mail address (retype):
Password:

* Your password must be a minimum 6 characters, with letters and numbers.

* The system is case-sensitive.
Password (retype):
Company/Institution/Organization Name:
Section/Division/Department:
Job title:
Address:
City:
State:
Zip:
Work Phone:
Mobile Phone:
Date of Birth (dd/mm/yyyy):
Cycling experience:
Height (cm) (To confirm bicycle size):
Whether or not bicycles are brought in:
Dietary allergies：
Please specify the details if any：
Dietary restrictions for religious reasons：
Please specify the details if any：
Languages other than native language in which daily conversation is possible：
Remarks (other questions, requests, etc.)：