Name
*
First Name
Last Name
Address
*
MUFG Office
*
Email
*
Contact telephone number
*
Emergency Contact Name
*
First Name
Last Name
Emergency contact telephone number
*
Would you like to rent a bike
Please select
No thanks
Yes please - a member of our team will contact you
Do you have any dietary requirements/food allergies?
*
Select from list
No
Yes - Please see details below
Do you have any non-food allergies and/or conditions?
*
Select from list
No
Yes - please provide details in the blank box below
Do you have any recurring joint or back problems?
*
Select from list
No
Yes - please provide details in the blank box below
Do you have any medical conditions (Asthma, Epilepsy, Angina, High Blood Pressure etc) ?
*
Select from list
No
Yes - please provide details in the blank box below
Do you have any medical allergies? (Penicillin etc)
*
Select from list
No
Yes - please provide details in the blank box below
Please list any medication you take or require below?
Is there anything else you wish to let us know?
Medical consent
*
Evening Meal Day 1 - Green Dragon Pub, Marlborough
Evening Meal Day 2 - White Lodge Restaurant, Taunton
Evening Meal Day 3 - Las Iguanas, Torquay
Return train travel (if no time selected you will be booked on the 11.59 train)
Please select time below
09.36 am
10.42am
11.02am
11.59am
12.59pm
14.21pm
14.59pm
16.20pm
Other - please enter time and date below (Additional charges may apply)
My insurance cover
*
All participants must have cycling activity, travel, and medical insurance cover valid in the UK. Please tick all boxes below.
My agreement
*
Consent
*
Terms & Conditions (available below)
*
