1. Name
*
First Name
Last Name
2. Address
*
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
3. Email address
*
4. Mobile phone number
*
5. Company / Organisation name
*
Please select
Blackstone
Bedell Cristin
Deloitte
Hexaware
Mileway
Mourant
MUFG
Pegasystems
PwC
Revantage UK
Revantage North America
Revantage Luxembourg
Revantage Amsterdam
Sanne Aspect
Salesforce
Simpson Thacher & Bartlett LLP
St. Modwen
Other (Please list below)
TFA Cycling Guide
6. Date of birth
MM
DD
YYYY
7. Emergency contact name
*
8. Emergency contact number
*
9. Passport Number
*
10. Passport expiry date
*
11. Passport country of issue
*
12. Do you have any dietary requirements/food allergies?
*
Please Select
YES (Please provide details below)
NO
13. Do you have any non-food allergies and/or conditions?
*
Please select
YES (Please provide detail below)
NO
14. Do you have any recurring joint or back problems?
*
Please select
YES (Please provide details below)
NO
15. Do you have any medical conditions (Asthma, Epilepsy, Angina, High Blood Pressure etc)
*
Please select
YES (Please provide details below)
NO
16. Do you have any medial allergies? (Penicillin etc)
*
Please select
YES (Please list details below)
NO
17. Are you taking or require any medication?
*
Please select
YES (Please list details below)
NO
18. Is there anything else you wish to let us know?
*
Please select
YES (Please add detail below)
NO
19. Medical consent
*
21. Hotel Night 1
*
Please select the type of room you would like
Single occupancy room (subject to availability and additional charges apply from £139)
Shared room (do not mind who I share with)
Shared room (please can I share with the person listed below)
22. Hotel Night 2
*
Please select the type of room you would like
Single occupancy room (subject to availability and additional charges apply from £149)
Shared room (do not mind who I share with)
Shared room (I would like to share with person listed below)
23.Hotel Night 3
*
Please select the type of room you would like
Single occupancy room (subject to availability and additional charges apply from £199)
Shared room (do not mind who i share with)
Shared room (I would like to share with the person listed below)
24. I would like to return to London on the following Eurostar?
*
Please select date and time (All subject to availability & additional cost may apply)
Paris to London - 16 June at 12.12pm
Other - Please add date/time below. Additional charges and admin fee apply.
25. My cycling shirt size is
*
Size guide to right of size (W-Women's dress size / M-Mens chest size). Size up for a looser fit or down for a tighter fit. Guide is available below.
26. Would you like to rent a bike?
*
Please select
NO
YES - A member of our team will be in touch
27. The make, model and value of the bike you will be riding on the challenge?
*
29. My agreement
*
30. My contact details
*
31. Insurance agreement (please check all boxes below)
*
32. GDPR Agreement (Privacy policy available below)
*
33. Terms & Conditions (available below)
*
34. I am happy for TFA Events to add me to the challenge WhatsApp group, using the number I entered above on this form. The group is the key way challenge information is shared.
