UK End to End Virtual Cycle Registration Form Welcome to the UK End to End Virtual Cycle Challenge registration form This is a virtual event, which uses the free, award-winning Pilgrims Event App and MapMyTracks companion app for smartphones to track your virtual progress along the UK End to End route. All activities logged using the app between 1st February - 31st December 2021 will be included in your overall progress. Instructions on how to track your progress will be contained within your entry confirmation email. Your details Title*MrMissMrsMsDrOtherOther* First name* Surname* Your Gender*MaleFemaleAddress* Street Address Address Line 2 City County Postcode This should be the same as the billing address of the card used at checkout. Contact details Contact mobile numberEmail address* Enter Email Confirm Email Must be checked regularly (this is the most effective way for us to communicate event information with you)By submitting this form, you consent to be contacted by email for the purpose of this event. If you'd like to receive emails about other exciting ways to support Pilgrims Hospices or with news about our work, please tick the box below. I am happy to receive emails where possible You can update your contact preferences at any time by calling our Supporter Relations Team on 01227 782062 or by writing to us at Pilgrims Hospices, Supporter Relations, 56 London Road, Canterbury, Kent, CT2 8JA.We are registered under the Data Protection Act and will never share, sell or swap your details with any third party for the purposes on their own marketing or the monetising of your data.About your participationIn the UK End to End Virtual Cycle, you have the freedom to decide the time frame in which you hope to complete the 900 mile journey. You could aim to complete the ride within 1 month, 3 months, 6 months, before the 31st December 2021, or any other time frame of your choice. Let us know below and we will support you to achieve your goal.Select your challenge time frame* 1 month challenge 3 month challenge 6 month challenge Before 31st December 2021 When will you start your challenge? MM slash DD slash YYYY Let us know the date on which the challenge time frame above will begin.Are you taking part in memory of a loved one? (If yes, please provide their full name and relationship to you) eg. John Smith (father)All those who complete the full UK End to End distance before 31st December 2021 will be entered into the Rider's Hall of Fame in recognition of their achievement. Please tick the box below to indicate you are happy to be included in the Hall of Fame. Yes, I am happy for my Map My Tracks username to appear in the Rider’s Hall of Fame What is your Map My Tracks username? If you have an existing Map My Tracks account already, please tell us your username for the Hall of Fame. If you haven't set one up yet, you can leave this blank.Entry - Participant 1 Price: I would like to add a donation for Pilgrims Hospices to my entry of:Please select£10 could pay for a patient's meals for the day£25 could pay for an hour of nursing care£30 could pay for our Community Team to hold a video consultation with a patient in their own home£45 could pay for a virtual counselling session for an individual coping with the loss of a loved oneShow your support with the official Pilgrims Hospices Cycle Jersey and Neck Scarf The Pilgrims cycle jersey is a stylish, quality garment, packed with great features such as a zipped valuables pocket, full length zip and silicone waist gripper. The Pilgrims Hospice Neck Warmer is a multifunctional accessory suitable for all conditions and purposes. Benefitting from Hot & Cold technology, our Neck Warmers are designed to keep you warm when it’s cold, and to wick moisture away when it’s hot with our exclusive Qwick-Dri™ technology. What’s more, the lightweight nature of the fabric ensures it’s comfortable to wear for prolonged period of time.Sizes available: XS, S, M, L, XL, XXL Jersey sizing guidePlease tick the box below if you would like a Pilgrims Hospices cycle jersey I wish to add a Pilgrims Hospices cycle jersey to my registration Please indicate the number of Pilgrims Hospices cycle jerseys you would like to add to your registration. Quantity* Price: £ 35.00 Quantity If you purchase one or more cycle jerseys, these will be dispatched to your address provided above within 7 days.jersey size(s) required* Pilgrims Hospices cycle jerseys are available in the following unisex sizes: XS, S, M, L, XL, XXLPlease tick the box below if you would like a Pilgrims Hospices neck scarf I wish to add a neck scarf to my registration Please indicate the number of neck scarves you would like to add to your registration. Quantity* Price: £ 5.00 Quantity If you purchase one or more neck scarves, these will be dispatched to your address provided above within 7 days.I understand that I take part in the UK End to End Virtual Cycle Challenge at my own risk and agree that I will follow the latest Government guidance regarding social distancing measures at all times while conducting my cycling activities. I am solely responsible for any injury, illness or loss of property I may incur through the activity and the Pilgrims Hospices will not be liable in any circumstance. I agree to abide by any terms and conditions of the event as agreed by the organisers. I undertake at all times to behave responsibly. I agree to follow any and all safety instructions given by the organisers before and during the event. (Please tick to indicate that you have read and agree to the disclaimer)* I agree Total £ 0.00 This is a virtual event and full instructions on how to track your progress for the UK End to End Virtual Cycle will be contained within your entry confirmation email sent upon completion of checkout.