Encouragement Program Claim Form

First Name

Last Name

Your Email

12 digits Torzc wheels serial Number
(required)

Event organizer

Name of the event

Category of the event
---Age group/master raceOpen raceMulti-stage tour (Single Stage)Multi-stage tour (GC)UCI 2.1 or aboveKOM

Result
---Winner1st runner up2nd runner upTop 10 finishKOM

Photo of the official result sheet

Your social media post of the event (eg. Facebook/Instagram link)

By checking the box, you declare that the information provided above are true and correct to the best of your knowledge.