L2P - Rider Info Form (UK)

Street Address

City, State, Zip

Phone Number

Your Custom Text Here

London to Paris cycle challenge
Rider information form

Please complete the rider info form below.

PERSONAL INFORMATION

Name

As it appears on your passport

First Name

Last Name

Address

MUFG Office

Contact telephone number

Emergency Contact Name

First Name

Last Name

Emergency contact telephone number

Cycling Shirt Size

To view Size Guide, please see link below this form

Would you like to rent a bike

Please ignore this question if not applicable

DIETARY, ALLERGY & MEDICAL INFORMATION

This information may be shared with medical professionals and event partners.

Do you have any dietary requirements/food allergies?

Do you have any non-food allergies and/or conditions?

Do you have any recurring joint or back problems?

Do you have any medical conditions (Asthma, Epilepsy, Angina, High Blood Pressure etc) ?

Do you have any medical allergies? (Penicillin etc)

Please list any medication you take or require below?

Is there anything else you wish to let us know?

Medical consent

I have declared any medical conditions that might be relevant and I will declare any more information should it arise between now and the end of the London to Paris cycle challenge. This information will be kept confidential at all times and will only be shared with medical and emergency professionals who require this information. I understand that if i have any questions I can contact The Fundraising Agency in confidence via events@tfaltd.co.uk. This information will be purged on 25 September 2022

MENU CHOICES (if applicable)

Please make your choices below. All other meals are a self-service buffet/order on the day.

Evening Meal Day 1 - Brewers Fayre, Newhaven (SEE MENU BELOW)

My insurance cover

All participants must have cycling activity, travel, and medical insurance cover valid in the UK.

I have insurance to cover me for cycling activities in UK & France.

I have travel insurance to cover me for any loss, damage, theft to my bike and my possessions.

I have medical insurance to cover me for any medical expenses incurred.

My agreement

By checking this box I agree that if I do not have the required insurance cover (cycling, travel and medical), I will be liable for any additional costs incurred.

Consent

I agree the information I submit will only be used by The Fundraising Agency Limited to administer and send me further details with regards to the London to Paris 2021 cycle challenge. This information will then be purged on 1st October 2022. By ticking this box I also agree to the terms and conditions, which are available in the link below. If you have any questions, please contact enquiries@tfaltd.co.uk.

Terms & Conditions (available below)

I agree to the terms and conditions

CYCLING SHIRT - SIZE GUIDE | EVENING MEAL DAY 1 - MENU

London to Paris cycle challenge
Rider information form

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MUFG Fitprints for Good website is owned and managed by TFA Events Limited. TFA Events Limited is a limited company, whose registered company address is 71-75 Shelton Street, Covent Garden, London, United Kingdom, WC2H 9JQ, and registered company no. 15143659. Terms & Conditions | Privacy Policy

London to Paris cycle challengeRider information form

London to Paris cycle challenge
Rider information form