Event Registration- Ride of the Roses

Join us for a charity bike ride on Sunday 3 September 2017.

Your Details

Choose your route: *

Surname: *

First Name: *

Address 1: *

Address 2: *

Address 3:

Postcode: *

Telephone: *

Email Address: *

We will need an emergency contact for the day of the event. Please tell us their name and phone number: *

Would you like to order a t-shirt?

Order today and pay just £5 each

Would you like to order a t-shirt? *

Please choose your size:

Extra Registrants

(if you would like to register more than 7 people, please call us on 0151 482 7948. Each registration costs £20

How many people are you registering? (Including yourself)

Add an extra registrant?:

Extra Registrant 1

Surname :

First Name :

Address 1 :

Address 2 :

Address 3 :

Postcode :

Telephone :

Email Address :

Would they like to order a t-shirt?

We will need an emergency contact for the day of the event. Please tell us their name and phone number :

Please choose their size:

Add an extra registrant?:

Extra Registrant 2

Surname-

First Name-

Address 1-

Address 2-

Address 3-

Postcode-

Telephone-

Email Address-

Would they like to order a t-shirt?

We will need an emergency contact for the day of the event. Please tell us their name and phone number-

Please choose their size:

Add an extra registrant?:

Extra Registrant 3

Surname -

First Name -

Address 1 -

Address 2 -

Address 3 -

Postcode -

Telephone -

Email Address -

Would they like to order a t-shirt?

We will need an emergency contact for the day of the event. Please tell us their name and phone number -

Please choose their size:

Add an extra registrant?:

Extra Registrant 4

Surname :

First Name :

Address 1 :

Address 2 :

Address 3 :

Postcode :

Telephone :

Email Address :

We will need an emergency contact for the day of the event. Please tell us their name and phone number :

Would they like to order a t-shirt?

Please choose their size:

Add an extra registrant?:

Extra Registrant 5

Surname >

First Name >

Address 1 >

Address 2 >

Address 3 >

Postcode >

Telephone >

Email Address >

Would they like to order a t-shirt?

We will need an emergency contact for the day of the event. Please tell us their name and phone number >

Please choose their size:

Add an extra registrant?:

Extra Registrant 6

- Surname:

- First Name:

- Address 1:

- Address 2:

- Address 3:

- Postcode:

- Email Address:

- Telephone:

Would they like to order a t-shirt?

- We will need an emergency contact for the day of the event. Please tell us their name and phone number:

Please choose their size:

Add an extra registrant?:

Extra Registrant 7

Surname :

First Name :

Address 1 :

Address 2 :

Address 3 :

Postcode :

Email Address :

Telephone :

Would they like to order a t-shirt?

We will need an emergency contact for the day of the event. Please tell us their name and phone number :

Please choose their size:

Participation

Why are you taking part *

If you have a special reason for taking part, would you be happy to share?

How did you hear about the event? *

Would you like to make an additional donation to the charity?

This is a personal donation. I would like the charity to reclaim Gift Aid on this, any donations I make in the future or have made in the past four years, to The Clatterbridge Cancer Charity. I am a UK taxpayer and understand that if I pay less Income Tax and/or Capital Gains Tax than the amount of Gift Aid claimed on all my donations in that tax year, it is my responsibility to pay any difference. The Clatterbridge Cancer Charity will claim 25p on every £1 you donate.

Total amount to pay:

How would you like to pay? *

Complete Registration

Terms & Conditions:

I understand that this is a fundraising event and pledge to raise as much sponsorship as possible
I understand that entry fees are non-refundable as they cover the costs of holding the event
I understand that this is not a race
I understand I MUST wear my official number on the day
I understand cycling can be a dangerous activity and that I participate in this event at my own risk and that the organisers cannot be held responsible for any injury, accident, loss, damage or public liability caused or sustained as a result of my participation
I will abide by all the rules and regulations set out by The Clatterbridge Cancer Charity
I understand this is an active challenge and confirm that I am in a reasonable state of health and fitness; if I have concerns about my physical condition to take part in this event I will consult my doctor first
I understand that The Clatterbridge Cancer Charity may take photographs of me participating in this event and permit the charity to use these images for promotional purposes If I am signing for a child I give permission to use their image
Minimum age is 14, if I am signing for someone under 16, I am their parent or guardian and confirm they will be accompanied by a responsible adult.
This is my written permission for their participation
I understand The Clatterbridge Cancer Charity require me to wear a cycling helmet for the duration of the ride and expect all cyclists to obey the rules of the Highway Code at all times during the event and should not cycle more than two abreast
That I have read and accepted the conditions of entry to the Ride of the Roses and the rules and regulations of this event

I accept the Terms and Conditions of entry: *