Register for the Cycling Challenge

First Name

Last Name

Address Line 1

Address Line 2

City

Postcode

Telephone Number

Email

Email Confirmation

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Emergency Contact

Name

Telephone Number

Relationship

T-Shirt Size

What size T-Shirt would you like?SmallMediumLarge

Disclaimer

I agree to abide by the rules of the Cyclists Highway Code

I understand that I will enter this challenge at my own risk and that no person(s) or organisation(s) will be held responsible for any accident, injury or loss to me prior to, during or after the event. This information will be held in accordance with the Data Protection Act 1998 and will be used for the purposes of administration only.

Entry fee is non-refundable.

I agree to the terms and conditions of entrance as stated in the above disclaimer.

Do not populate this field

Register by Post

If you prefer not to use an online registration form. You can download a form from here in both Acrobat PDF and Microsoft Word formats.

Registration Form

Word version. PDF version.

Ffurflen Cofrestru

Fersiwn Word. Fersiwn PDF.

Fill in a form and send it to us along with a cheque to the address below.

Len Smith
Ffestiniog 360
c/o Antur Stiniog
Units 1 & 2
High Street
Blaenau Ffestiniog
Gwynedd
LL41 3ES

Cheque's to be made payable to "Ffestiniog 360" Entry fee is non-refundable.

Sponsorship

Help us raise more money for Tŷ Gobaith Children’s hospice by collecting sponsorship from your family and friends.

If you don't want to use JustGiving you can download sponsorship forms. Front page, Additional page.