2020 Credit / Debit Card Autumn Classic Payment Form

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Autumn Classic Sportive Registration Form
Please complete all rider details below before clicking PAY NOW.

Thanks Norfolk Cycling Events

My Products *

Autumn Classic Sportive (25,50,75,100 miles) £ 15.50 GBP

Quantity

Autumn Classic 10 miles £ 10.00 GBP

Quantity

Autumn Classic Under 16's £ 1.95 GBP

Quantity

Break Charity Donation £ 5.00 GBP

Quantity

Total £ 0.00 GBP

1st Rider Form
Full Name *

First Name Last Name
E-mail *

Confirmation Email
Address *

Street Address

Street Address Line 2

City / Town County

Postcode Country
Rider Phone Number *

Phone Number
Emergency Contact Name *

First Name Last Name
Emergency Contact Number *
Land Line / Mobile
Agree to NCE Terms & Conditions *

YES = Ride NO = NO Ride
Please Note: There must be one full paying adult to 1 x under 16. Entries will be rejected if this is not the case.

2nd Rider Form
Full Name

First Name Last Name
E-mail
Address

Street Address

Street Address Line 2

City / Town County

Postcode Country
Phone Number

Area Code Phone Number
Emergency Contact Name

First Name Last Name
Emergency Contact Number
Land Line / Mobile
Agree to NCE Terms & Conditions

YES = Ride NO = NO Ride Under 16 Rider 10 miles Under 16 Rider up to 50 miles max

3rd Rider Form
Full Name

First Name Last Name
E-mail
Address

Street Address

Street Address Line 2

City / town County

Postcode Country
Phone Number

Area Code Phone Number
Emergency Contact Name

First Name Last Name
Emergency Contact Number
Land Line / Mobile
Agree to NCE Terms & Conditions

YES = Ride NO = NO Ride Under 16 Rider 10 miles Under 16 Rider up to 50 miles max

4th Rider Form
Full Name

First Name Last Name
E-mail
Address

Street Address

Street Address Line 2

City / town County

Postcode Country
Phone Number

Area Code Phone Number
Emergency Contact Name

First Name Last Name
Emergency Contact Number
Land Line / Mobile
Agree to NCE Terms & Conditions

YES = Ride NO = NO Ride Under 16 Rider 10 miles Under 16 Rider up to 50 miles max

5th Rider Form
Full Name

First Name Last Name
E-mail
Address

Street Address

Street Address Line 2

City / town County

Postcode Country
Phone Number

Area Code Phone Number
Emergency Contact Name

First Name Last Name
Emergency Contact Number
Land Line / Mobile
Agree to NCE Terms & Conditions

YES = Ride NO = NO Ride Under 16 Rider 10 miles Under 16 Rider up to 50 miles max

6th Rider Form
Full Name

First Name Last Name
E-mail
Address

Street Address

Street Address Line 2

City / Town County

Postcode Country
Phone Number

Area Code Phone Number
Emergency Contact Name

First Name Last Name
Emergency Contact Number
Land Line / Mobile
Agree to NCE Terms & Conditions

YES = Ride NO = NO Ride Under 16 Rider 10 miles Under 16 Rider up to 50 miles max
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Autumn Classic Sportive Registration Form