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Cycle Challenge Registration form

Your route
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Registration for all routes: £25 (closing date 24/04/16). After the closing date, 'on the day' registration will be available at £45.

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Date of birth

You must be 14 or over to take part in the Cycle Challenge. If you are between the ages of 14 and 17, a parental consent form must be completed and brought with you on the day. Under-18s must be accompanied by an adult.

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Your details
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Contact details
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We are registered under the Data Protection Act and will not disclose your details to any other organisation.

By submitting this form, from time to time we may email you with news we think may interest you about our work and the ways you may support us.

You can update your contact preferences at any time by calling our Supporter Services Team on 01227 782062 or by writing to us at the address below.

Emergency contact details
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Additional registrant route
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Registration for all routes: £25 (closing date 24/04/16). After the closing date, 'on the day' registration will be available at £45.

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Details for the additional registrant
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Additional registrant route
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Registration for all routes: £25 (closing date 24/04/16). After the closing date, 'on the day' registration will be available at £45.

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Details for the additional registrant
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Additional registrant route
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Registration for all routes: £25 (closing date 24/04/16). After the closing date, 'on the day' registration will be available at £45.

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Details for the additional registrant
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Additional registrant route
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Registration for all routes: £25 (closing date 24/04/16). After the closing date, 'on the day' registration will be available at £45.

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Details for the additional registrant
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Additional registrant route
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Registration for all routes: £25 (closing date 24/04/16). After the closing date, 'on the day' registration will be available at £45.

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Details for the additional registrant
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