2019 Credit / Debit Card Round Norfolk Epic 2 day Payment Form

Round Norfolk Epic 2 day Registration Form 2019

200 miles 2 days
Please complete all rider details below before clicking PAY NOW.

Thanks Norfolk Cycling Events.

My Products *

Round Norfolk Epic Ride (ride only) £ 62.50 GBP

Quantity

Round Norfolk Epic Ride 6 for the price of 5 (ride only) £ 312.50 GBP

Quantity

Hotel Room single £ 95.00 GBP

Quantity

Hotel Room Double £ 105.00 GBP

Quantity

Hotel Room Twin (Per Person) £ 52.50 GBP

Quantity

Break Donation £ 5.00 GBP

Quantity

Total £ 0.00 GBP

Address *

Emergency Contact Name *

First Name Last Name
Emergency Contact Number *
Land Line or Mobile
T-Shirt *
If you have picked twin or double room and want to share with another rider please include their name here.
Twin Room Buddy.
Dietary Requirements *
Dietary Requirements for feed-zones only
Agree to NCE Terms & Conditions *

YES = Ride NO = NO Ride

Address

Phone Number

- Area Code Phone Number
Emergency Contact Name

First Name Last Name
Emergency Contact Number
Land Line or Mobile
T-Shirt
If you have picked twin or double room and want to share with another rider please include their name here.
Twin Room Buddy.
Dietary Requirements
Dietary Requirements for feed-zones only
Agree to NCE Terms & Conditions

YES = Ride NO = NO Ride

Address

Phone Number

- Area Code Phone Number
Emergency Contact Name

First Name Last Name
Emergency Contact Number
Land Line or Mobile
T-Shirt
If you have picked twin or double room and want to share with another rider please include their name here.
Twin Room Buddy.
Dietary Requirements
Dietary Requirements for feed-zones only
Agree to NCE Terms & Conditions

YES = Ride NO = NO Ride

Address

Phone Number

- Area Code Phone Number
Emergency Contact Name

First Name Last Name
Emergency Contact Number
Land Line or Mobile
T-Shirt
If you have picked twin or double room and want to share with another rider please include their name here.
Twin Room Buddy.
Dietary Requirements
Dietary Requirements for feed-zones only
Agree to NCE Terms & Conditions

YES = Ride NO = NO Ride

Address

Phone Number

- Area Code Phone Number
Emergency Contact Name

First Name Last Name
Emergency Contact Number
Land Line or Mobile
T-Shirt
If you have picked twin or double room and want to share with another rider please include their name here.
Twin Room Buddy.
Dietary Requirements
Dietary Requirements for feed-zones only
Agree to NCE Terms & Conditions

YES = Ride NO = NO Ride

Address

Phone Number

- Area Code Phone Number
Emergency Contact Name

First Name Last Name
Emergency Contact Number
Land Line or Mobile
T-Shirt
If you have picked twin or double room and want to share with another rider please include their name here.
Twin Room Buddy.
Dietary Requirements
Dietary Requirements for feed-zones only
Agree to NCE Terms & Conditions

YES = Ride NO = NO Ride
Should be Empty:

Round Norfolk Epic 2 day Registration Form 2019