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

Address *

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.

Address

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

Address

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

Address

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

Address

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

Address

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
Should be Empty:

Autumn Classic Sportive Registration Form