PRUDENTIAL RIDELONDON-SURREY 100
SUNDAY 30th JULY 2017
GOLDEN BOND APPLICATION FORM

This application requires a £50 registration fee,  please have your payment details to hand.
Begin Application
 
The Neuro Foundation holds a limited number of Golden Bond (guaranteed) places for the Prudential RideLondon 100 in 2017. Therefore, we ask that all Golden Bond cyclists pledge to raise a minimum of £450 for The Neuro Foundation. This excludes a £50 non-refundable registration fee.

Of course, we will do whatever we can to assist your fundraising efforts! This pledge is your first step to joining the NFAUK RideLondon 100 Team.
 
Title and Full Name: *

 
Address (including postcode): *

 
D.O.B *

 
Occupation and name of company:

 
Please let us know if you have applied to the official RideLondon 100 ballot: *


 
Have you taken part in a cycling event before? If yes, please provide details:

 
What is the target time in which you hope to complete the Prudential RideLondon 100?

Do not worry we will not hold you to this. A typical average is around 5-7 hours, but you have as long as
9 hours. It is always good to have a target to aspire to.
 
Cycle jersey size: *

The Neuro Foundation will provide all riders with a cycle jersey for the event. If you require a different size please inform us ASAP.

 
Size required if 'other':

just scroll on, or press enter if not applicable.
 
Name to be printed on jersey: *

 
Please Gift Aid Your Donation
UK Taxpayers are eligible to increase their donations, by 25% at no extra cost to yourself. Please confirm the following statements:

• I am a UK tax payer.
• I would like The Neuro Foundation to claim GiftAid on all my donations at no cost to me, from this date onwards until further notice.
• I will notify The Neuro Foundation in writing if my circumstances change and I am no longer paying sufficient tax to qualify for Gift Aid. 
*

If you are a UK taxpayer, under the Government’s Gift Aid scheme The Neuro Foundation can claim the tax you have already paid on your gift. This means that your donation can increase in value by at least 25% at no extra cost to you.  Please note Gift Aid does not apply to the £50 registration fee.
     
 
Terms & Conditions *

• The Neuro Foundation reserves the right to refuse an application at its absolute discretion.
• Participants must pay a £50 non-refundable registration fee.
• By agreeing to these terms & conditions you are committing to raise a minimum of £450 for the charity (excluding Gift Aid)
• You must be 18 years or over on the day of the race. 
• You must undertake the necessary training, nutritional and health advice in order to cycle the Prudential RideLondon 100 as safely as possible. The Neuro Foundation cannot be held responsible for any injuries or loss occurred through participation in this event.
• If you are unwell on the day of the event, you should not participate. If you are unwell during training, you must seek the correct medical advice as to whether you should cycle.
• If you are unable to participate in the event for any reason, all donated monies collected in support of the NF must be forwarded to the charity or returned to the individual sponsors. Monies already received by the charity will not be refunded. You must contact the charity immediately if you think you are going to be unable to participate.
• By signing up to the Prudential RideLondon 100 you are consenting to the NF using any images of you in their promotional materials.

Please read the following declaration before accepting the terms & conditions:

I, {{answer_48766510}} have read and understood the terms and conditions above and would like to apply for a Golden Bond place to cycle for The Neuro Foundation. I understand by accepting a Golden Bond Place from The Neuro Foundation, I am undertaking a pledge to raise a minimum of £450 for The Neuro Foundation. I also confirm I will be 18 years of age by 30th July 2017.

     
 
By completing this section of the form, you will be charged {{var_price}} and secure your Golden Bond Place to take part in the Prudential RideLondon 100 for The Neuro Foundation. This is required to register. *

Your payment details will not be stored by The Neuro Foundation.
 
Please enter your Credit or Debit Card number: *

 
The CVC number: *

(3 or 4 digit security number on the back of your card)
 
The name on your card: *

 
Your card's expiry month: *


 
Your card's expiry year: *


{{answer_48766510}}, one last step:  Register your #RIDEFORNF Fundraising Page! We are using a great new fundraising service that helps you get the most out of your training by linking your fundraising page to fitness apps like Strava & MapMyFitness! It takes less than a minute to get started.
Register my Fundraising Page Now!
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