Prudential RideLondon-Surrey 100 (2019)

Applicant information

Please provide the following information about yourself.

  
Please specify below, if you selected 'Other' option in previous question
 
Additional contact - This must be at a separate address

Please enter an additional contact. If you enter your own details here your application will not be processed.

Declarations

 Phab reserves the right to withdraw any applicant at any time.

All places are subject to accepting our terms and conditions. Please see those linked here

I agree to run for Phab and to raise a minimum pledge of £400 excluding Gift Aid and should there be a shortfall in my fundraising, I agree to make this up personally.
I agree to Phab entering my personal details on the event management software.
I agree that Phab will keep my information on file for auditing purposes.
By ticking this box you confirm that your additional contact is aware that you have supplied their details to us and processing my data in line with the {privacy statement}.
By ticking this box you agree to Phab contacting you via email with content relating to this event.
By ticking this box you agree to Phab contacting you via email about fundraising/volunteering opportunities and other events that may be of interest to you.