The Big Welsh Bike Ride

Events

£250.00

...

Events | Ty Hafan Events

£25.00

This event is for people aged 18 or over. ...

Events | Ty Hafan Events

£8.00 – £10.00

Select your race distance below: ...

Your Details
Title *
Firstname *
Surname *
Are you registering as part of a company? If so, please let us know your company name:
Company Name
Address 1 *
Address 2
Town *
Postcode *
Email *
Telephone *
Date of Birth *
Cycle jersey size

Are you a Welsh speaker?	Yes No
Gender	Male Female


Medical information
Do you have any medical conditions, including allergies or medications that we should be aware of?
*	Yes No
If yes, please provide further information below:
Do you have any health conditions (physical or otherwise) that we need to be aware of, or any special adjustments you might require to participate in the event?
*	Yes No
Do you have any dietary requirements?


Next of kin information
Next of Kin Name *
Next of Kin relationship to you *
Next of Kin contact number *

I agree to raise the minimum fundraising target for this challenge of £1950 *
I acknowledge that by signing up to this event that Tŷ Hafan will contact me about the event and supporting me with my fundraising

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