UTMR Forms Table of Contents — first form —2018 PRE-REGISTRATION— next form —2018 UTMR Registration Form170km Ultra Tour4-day Stage RaceYour personal detailsEMERGENCY CONTACTStage race accommodationRULES AND REGULATIONSMEDICAL CERTIFICATEINSURANCETERMS AND CONDITIONSPAYMENT— next form —National ID upload form— next form —Medical Certificates— end — — first form — 2018 PRE-REGISTRATION Please complete this form and click the green button at the end to submit. You will receive an email confirmation that your form has been submitted. Thank you! Race*Please indicate which race you would like to pre-register for. 170km Ultra Tour4-day stage race, 170km100km Ultra 3 PassesYou are pre-registering for the 170km Ultra TourYou are pre-registering for the 170km 4-day Stage RaceName* First Last Email* Enter Email Confirm Email Gender*FemaleMaleDate of Birth* Date Format: YYYY dot MM dot DD NATIONALITY*AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSudan, SouthSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabwePhone Number*Please include international code.Race history for stage race participants*Please tell us all your relevant race experience, including distance of race, ascent / descent, your finish time, year of race. Simply click the + button to add another race. For the stage races you need to have completed a multi-stage race on mountain terrain or have completed a mountain marathon with ~2000m ascent in a time of 8 hours. Race nameRace websiteNumber of stages (if a stage race)Distance (km)Elevation change (m)Finish timeMonth / Year Race history for 170km ultramarathon participants*For the 170km ultramarathon you need to have completed one of the qualifying races (see) in 2014, 2015 or 2016 OR be a finisher of the 2016 UTMR Ultra. Please tell us all your relevant race experience, including distance of race, ascent / descent, your finish time, number of hours of night time running, year of race. Simply click the + button to add another race. If you don't have a finish at any of these races please complete this form and additionally write to info@ultratourmonterosa.com to explain your experience and why we should offer you a place. Race nameRace websiteStart time of raceDistance (km)Elevation change (m)Hours of night runningFinish timeMonth / year Race history for 100km ultramarathon participants*For the 100km ultramarathon you need to have completed a 80-100km race in mountain terrain or the UTMR stage race AND have completed a running race in mountain terrain requiring at least six hours of night running during 2015 to 2017. Please tell us all your relevant race experience, including distance of race, ascent / descent, your finish time, number of hours of night time running, year of race. Simply click the + button to add another race. If you don't have a finish at any of these races please complete this form and additionally write to info@ultratourmonterosa.com to explain your experience and why we should offer you a place. Race nameRace websiteStart time of raceDistance (km)Elevation change (m)Hours of night runningFinish timeMonth / year Additional race historyIf you have any additional information please include it here.Mountain Experience*Please add here any other mountain experience that you have to help us assess your ability to cope with the demands of the terrain and to look after yourself under all conditions. This might include any climbing or mountaineering experience, multi-day trekking, or experience in a mountain environment in all weather conditions. Further comments or questions.We will do our best to answer any questions promptly!How did you hear about this race?* — next form — 2018 UTMR Registration Form Please fill out this form to complete your registration and payment for the 2018 Ultra Tour Monte Rosa. You will receive an email confirmation that your form has been submitted and payment received. Thank you and we look forward to seeing you in September! Race*170km Ultra Tour4-day stage race, 170km100km Ultra 3 Passes170km Ultra Tour You are registering for the 170km Ultra Tour. If this is not the race that you want to enter please email info@ultratourmonterosa.com.4-day Stage Race You are registering for the 4-day Stage Race. If this is not the race that you want to enter please email info@ultratourmonterosa.com.Your personal detailsName*Chinese runners please write: Western name + Chinese name + surname, e.g., "Janine Mei Yi Tan". First (birth name) Last (family name) Preferred name for race bib*See example.Date of Birth*Year20202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Month123456789101112Day12345678910111213141516171819202122232425262728293031Gender*FemaleMaleNationality*Afghanistan [AFG]Albania [ALB]Algeria [ALG]American Samoa* [ASA]Andorra [AND]Angola [ANG]Antigua and Barbuda [ANT]Argentina [ARG]Armenia [ARM]Aruba* [ARU]Australia [AUS]Australasia [ANZ]Austria [AUT]Azerbaijan [AZE]The Bahamas [BAH]Bahrain [BRN]Bangladesh [BAN]Barbados [BAR]Belarus [BLR]Belgium [BEL]Belize [BIZ]Bermuda* [BER]Benin [BEN]Bhutan [BHU]Bohemia [BOH]Bolivia [BOL]Bosnia and Herzegovina [BIH]Botswana [BOT]Brazil [BRA]British Virgin Islands* [IVB]British West Indies [BWI]Brunei [BRU]Bulgaria [BUL]Burkina Faso [BUR]Burundi [BDI]Cambodia [CAM]Cameroon [CMR]Canada [CAN]Cape Verde [CPV]Cayman Islands* [CAY]Central African Republic [CAF]Chad [CHA]Chile [CHI]China [CHN]Colombia [COL]Comoros [COM]Congo, Republic of the [CGO]Congo, Democratic [COD]Republic of the Cook Islands* [COK]Costa Rica [CRC]Cote d'Ivoire [CIV]Croatia [CRO]Cuba [CUB]Cyprus [CYP]Czech Republic [CZE]Czechoslovakia [TCH]Denmark [DEN]Djibouti [DJI]Dominica [DMA]Dominican Republic [DOM]East Germany [GDR]East Timor (Timor-Leste) [TLS]Ecuador [ECU]Egypt [EGY]El Salvador [ESA]Equatorial Guinea [GEQ]Eritrea [ERI]Estonia [EST]Ethiopia [ETH]Fiji [FIJ]Finland [FIN]France [FRA]Gabon [GAB]The Gambia [GAM]Georgia [GEO]Germany [GER]Ghana [GHA]Greece [GRE]Grenada [GRN]Guam* [GUM]Guatemala [GUA]Guinea [GUI]Guinea-Bissau [GBS]Guyana [GUY]Haiti [HAI]Honduras [HON]Hong Kong* [HKG]Hungary [HUN]Iceland [ISL]Individual Olympic athletes [IOA]Independent Olympic Participants [IOP]India [IND]Indonesia [INA]Iran [IRI]Iraq [IRQ]Ireland [IRL]Israel [ISR]Italy [ITA]Jamaica [JAM]Japan [JPN]Jordan [JOR]Kazakhstan [KAZ]Kenya [KEN]Kiribati [KIR]Korea, North (PDR of Korea) [PRK]Korea, South [KOR]Kosovo []Kuwait [KUW]Kyrgyzstan [KGZ]Laos [LAO]Latvia [LAT]Lebanon [LIB]Lesotho [LES]Liberia [LBR]Libya [LBA]Liechtenstein [LIE]Lithuania [LTU]Luxembourg [LUX]Macao (Special Admin. Region of China) - [MAC]Macedonia [MKD]Madagascar [MAD]Malawi [MAW]Malaya [MAL]Malaysia [MAS]Maldives [MDV]Mali [MLI]Malta [MLT]Marshall Islands [MHL]Mauritania [MTN]Mauritius [MRI]Mexico [MEX]Micronesia (Federated States of) [FSM]Mixed Team (1896 to 1904) [ZZX]Moldova [MDA]Monaco [MON]Mongolia [MGL]Montenegro [MNE]Morocco [MAR]Mozambique [MOZ]Myanmar (Burma) [MYA]Namibia [NAM]Nauru [NRU]Nepal [NEP]Netherlands [NED]Netherlands Antilles* [AHO]New Zealand [NZL]Nicaragua [NCA]Niger [NIG]Nigeria [NGR]North Borneo [NBO]North Yemen [YAR]Norway [NOR]Oman [OMA]Pakistan [PAK]Palau [PLW]Palestine* [PLE]Panama [PAN]Papua New Guinea [PNG]Paraguay [PAR]Peru [PER]Philippines [PHI]Poland [POL]Portugal [POR]Puerto Rico* [PUR]Qatar [QAT]Refugee Olympic Athletes [ROA]Republic of China [ROC]Romania [ROU]Russian Federation [RUS]Russian Empire [RU1]Rwanda [RWA]Saar [SAA]Saint Kitts and Nevis [SKN]Saint Lucia [LCA]Saint Vincent and the Grenadines [VIN]Samoa [SAM]San Marino [SMR]Sao Tome and Principe [STP]Saudi Arabia [KSA]Senegal [SEN]Serbia [SMR]Serbia and Montenegro [SCG]Seychelles [SEY]Sierra Leone [SLE]Singapore [SIN]Slovakia [SVK]Slovenia [SLO]Solomon Islands [SOL]Somalia [SOM]South Africa [RSA]South Sudan [SSD]South Yemen [YMD]Soviet Union [URS]Spain [ESP]Sri Lanka [SRI]Sudan [SUD]Suriname [SUR]Swaziland [SWZ]Sweden [SWE]Switzerland [SUI]Syria [SYR]Taiwan (Chinese Taipei) [TPE]Tajikistan [TJK]Tanzania [TAN]Thailand [THA]Togo [TOG]Tonga [TGA]Trinidad and Tobago [TRI]Tunisia [TUN]Turkey [TUR]Turkmenistan [TKM]Tuvalu [TUV]Uganda [UGA]Ukraine [UKR]Unified Team [EUN]Unified Team of Germany [EUA]United Arab Emirates [UAE]United Arab Republic [RAU]United Kingdom (Great Britain) [GBR]United States [USA]Uruguay [URU]Uzbekistan [UZB]Vanuatu [VAN]Venezuela [VEN]Vietnam [VIE]Virgin Islands* [ISV]West Germany [FRG]West Indies Federation (Antilles) [ANT]Yemen [YEM]Yugoslavia [YUG]Zambia [ZAM]Zimbabwe [ZIM]Residential address* Street Address Address Line 2 City ZIP / Postal Code Country AfghanistanÅland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarrussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRéunionRomaniaRussiaRwandaSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUS Minor Outlying IslandsUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabwe Mobile telephone number*Please include international dialing code. i.e. +49I will use this number during the raceAnswer no if you will get a new SIM & number laterYesNoMobile number carried during raceNB This MUST be the number of the phone you will have with you during the race. If you will get a new roaming SIM card for the race, leave this blank.What country is your phone registered in?*Email address* Enter Email Confirm Email T-shirt size (men's)*Note sizes in cm and inches. Size guide here.S - 90-93cm 35-37"M - 96-99cm 38-39"L - 102-105cm 40-41"XL - 108-111cm 43-44"XXL - 114-118cm 45-46"T-shirt size (women's)*Note sizes in cm and inches. Size guide here.XS - 82cm 32"S - 85-88cm 33-35"M - 91-94cm 36-37"L - 98-102cm 39-40"XL - 106-111cm 42-44"Participation in previous editions of UTMRIf you participated in a previous edition of UTMR (2015, 2016 or 2017) please enter your race number here!EMERGENCY CONTACTContact in case of emergency.Emergency contact - Name*Please give the name of someone we can contact for you in case of emergency. Emergency contact telephone number*Including international code e.g. 0039What country is this telephone registered in?*Stage race accommodationWe organise half-board accommodation for all race participants in shared rooms for Wednesday 6th September in Zermatt (4-stage only), Thursday 7th September in Gressoney-la-Trinite and Friday 8th September in Macugnaga.Room sharingIf you are coming with a friend or partner and would like to share a room please give the name here. We will do our best to arrange this if possible. GroupsIf you are coming in a group and would like to be placed in the same hotel please list the names here. We will do our best to arrange this if possible. Dietary RequirementsPlease indicate here if you have special dietary requirements for evening meal (vegetarian etc.). We will pass this information on to the hotel and they will do their best to accommodate your needs.RULES AND REGULATIONSRULES AND REGULATIONS* I have read, understood and accepted the UTMR RULES AND REGULATIONS MEDICAL CERTIFICATETo validate your registration we require a medical certificate completed and signed by your doctor. In case we do not receive your certificate your registration for the race will be cancelled. Form is here.MEDICAL CERTIFICATE* I confirm I will upload my medical certificate by 1st July 2018. INSURANCEAll race participants must have individual accident insurance which covers search and evacuation costs in Italy and Switzerland. PERSONAL ACCIDENT INSURANCE* I confirm I will have the necessary personal accident insurance to cover search and rescue in Italy and Switzerland. TERMS AND CONDITIONSTERMS AND CONDITIONS*Read the Terms & Conditions here. I have read, understood and accepted the UTMR TERMS AND CONDITIONS PAYMENTPayment is required to be able to complete this registration process. 4STAGE Registration Fee* Price: 730,00 € ULTRA170 Registration Fee* Price: 296,00 € ULTRA100 Registration Fee* Price: 185,00 € Total 0,00 € CouponIf we have given you a discount code please enter it here. Credit Card* American ExpressDiscoverMasterCardVisa Card Number Expiration Date Month010203040506070809101112 Year20192020202120222023202420252026202720282029203020312032203320342035203620372038 Security Code Cardholder Name CommentsThis field is for validation purposes and should be left unchanged. — next form — National ID upload form As your bags will be carried across international borders, we need to carry a copy of your ID with the bag in case customs wish to make checks. Please upload a valid ID document here. Files under 5MB preferred! Please be patient after clicking submit. Unique IDEntry IDYour id document*Can be an image (jpg) or PDF.Accepted file types: jpg, png, pdf.Name* First Last Your event*4STAGEULTRA170ULTRA100Chest/bib numberBib/dorsal number is assigned in July 2018. Ignore this until then.Please enter a number from 100 to 900.CommentsThis field is for validation purposes and should be left unchanged. — next form — Medical Certificates Name* First Last Email* Enter Email Confirm Email Medical Certificate*Please upload a copy of your signed Medical Certificate here. — end —