Registration
This registration form is a confirmation that you would like to be a cyclist in the Operation Flinders Epic Impact Bike Challenge 2021.
Name
*
First Name
Last Name
Date of birth
*
-
Month
-
Day
Year
Date
Email
*
example@example.com
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Dietary Requirements
*
T-Shirt Size
*
How did you hear about the event?
*
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Agreement
To ensure you understand key aspects of the event such as personal preparation, fundraising and milestones, it is a requirement that you read through the following document.
Cyclist Information Pack 2021
I understand the requirements in participating in the Operation Flinders Bike Challenge 2021
*
Yes
No
Signature
*
Thank you
The Epic Impact Bike Challenge is one of the Foundation's key fundraising events. Without the cyclists, we would not be able to raise the much needed funds required to assist in transforming the lives of young people at risk.
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