Ride to Give : Register

Personal Details

First Name *

Last Name *

Email Address *

Password*

Phone *

Date of birth *

Gender *

Male Female Other

Shirt Size *

Postal Address *

(enter address manually)

State *

Country *

Emergency Contact Details

Please provide us with an emergency contact

First Name *

Last Name *

Contact Number *

Relationship to you

Organisation Details

Organisation Name *

Your Position *

Join or Create a Team

No Thanks Join Create

Medical Conditions

Do you have any pre-existing medical conditions which might affect your ability to take part, or be relevant if treatment is needed?

Yes No

Dietary Requirements

Do you have any dietary requirements? *

Yes
No

Please tell us your coffee order

Logistics

Please upload a photo of yourself for our rider booklet

Your Cycling Experience

Which term best describes your cycling ability? *

How far do you ride on average a week? *

How often do you ride? *

Do you have Peloton riding experience? *

Yes
No

Are you a member of Aus Cycling? *

Yes
No

Anything else you’d like us to know?

Conditions for Entry

I accept the Terms and Conditions *

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REGISTRATION

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Personal Details

Postal Address *

Emergency Contact Details

Organisation Details

Join or Create a Team

Medical Conditions

Dietary Requirements

Logistics

Your Cycling Experience

Conditions for Entry

Rider kit sizes

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ACKNOWLEDGEMENT OF COUNTRY