London to Brighton – Registration

Please complete your details to confirm your place on our London to Brighton Invitation-only Cycling Event on Thursday 9th June.

Your personal details
Name*
First Last
Gender*
Date of Birth*

DD
MM
YYYY
Email*
Phone*
Company*
Job Title*
Arrival in Brighton
Will you be attending the celebration/networking meal in Brighton on the evening of 9th June? (No extra cost)*
- Yes please
- No thanks
Would you like us to organise overnight accommodation in Brighton on the night of the 9th June 2016?*
- Yes please - single room
- Yes please - happy to share a room
- No thanks
(This will incur an additional cost of between £50-£100 - to be confirmed once we have an idea of numbers)
Other details
Do you have any medical conditions we need to be aware of?
(We will ask you to confirm these details on the day of the event)
Do you have any dietary requirements?
(We will ask you to confirm these details on the day of the event)
Next of kin details
(We will ask you to confirm these details on the day of the event)
Next of kin name*
Next of kin phone number*

Your personal details