Temwa Brighton to Bristol Bike Ride Registration Form 17-19th September 2021
Thanks for joining #TeamTemwa and taking on this amazing 3 day challenge to support our work!

Please complete this form to confirm your participation.

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Full name *
Date of Birth *
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E-mail address *
Mobile number *
Other contact number
Address *
Where did you hear about this event? *
Are you taking part with someone else and if so what is their name?
What level cyclist are you? *
Emergency Contact Name *
Emergency Contact Relationship to you
Emergency Contact Phone number(s) *
Emergency Contact Email *
Are you happy for us to give you some online encouragement?
If so please give us details of your Facebook/Twitter/Instagram accounts
Keeping in Touch! *
We will keep you updated about the event via email, phone and post.  However, if you would also like to hear stories from overseas and other exciting fundraising campaigns and events then please join the Temwa movement then confirm your contact preferences below. You can get in touch to opt-out or change your preferences at any time. We will not pass on your details to third parties.                                                                                                
Required
Liability and Fundraising Agreement: *
Temwa can accept no liability for individuals taking part in this event on our behalf. The organisers will however take all necessary precautions to ensure your safety during the bike ride, but in signing up you are aware that you are responsible for yourself and your actions. You also agree to meet the minimum sponsorship amount as listed on the event page of £700, and consent to Temwa taking photos/video during the event to use in communications and future marketing of events.  You agree to treat all others involved in the event with respect and understand that Temwa has the right to ask you to leave the bike ride if you behaviour upsets or harms others.
Registration Fee *
In order to complete your registration to take part, you will need to pay a £75 non refundable registration fee to Temwa to secure your place. This fee will be used to cover some of the initial costs incurred in setting up an event of this nature. Should there be any reason that the event is unable to go ahead, Temwa will of course refund this fee.                                                                                                                                                                                  Please make a BACS payment to:  Temwa UK, Account 71614754, Sort Code 40-14-14 and use 'Bike Ride 2021' as the Reference
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