Billing Address
City

Guwahati

State/County

AS

First Name

Kajal

Second Name

Choudhury

Club

Luit Riders Axom

Blood Group

O+

Emergency Contact Name

Prakash Barman

Emergency Contact Number

9864051116

Sex

M

Motorcycle Registration Number (Optional)

AS01DS7185

Rider Mania's - I have attended

This is my first Rider Mania

Vaccination Status

Second Dose

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