Lake St Clair Bike Ride Charity Bike Ride in the Hunter Valley NSW

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READY TO REGISTER FOR THE LAKE ST CLAIR BIKE RIDE?

Fill in your details below

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Ride Registration – September 22nd 2018

REGISTRATIONS ARE NOW OPEN! Make sure you save the date, Saturday 22nd September 2018, and don’t forget to follow us on Facebook and Instagram for details!

Lake Ride Registration Form 2018 Early bird

Early Bird Entry! Enter before 22nd AUGUST 2018 and SAVE!
First Name*
Surname*
Personal Details
Street Address*
Suburb*
State*
Postcode*
Email*
Phone*
Club or Team Name (if applicable)
Emergency Contact Details
Emergency Contact Name*
Emergency Contact Number*
Medical conditions (if applicable)
Route Distance
Entries made after 9th June 2017 is an extra $10 per entrant
Choose ride distance*
- 75km Ride : $55.00 : Start 8:30am
- 48km Ride : $40.00 : Start 9:00am
- 16km Ride : $20.00 : Start 9:30am
T-Shirt $20.00
T-Shirt
- No T-Shirt
- XS
- S
- M
- L
- XL
- XXXL
Ride Jersey $60.00
Ride Jersey
- No Jersey
- XS
- S
- M
- L
- XL
- XXXL
To receive on the day, jersey orders MUST be in by Tuesday 8th August 2017. Limited sizes available - Get in quick!
Conditions: All entrants must read and agree to this declaration
Please click to read the Terms and Conditions - click here (opens in new tab) and please check the box below if you accept them to ride.
Agree to terms and conditions*
- I agree to the terms and conditions specified above
Entrant age*
- Entrant will be 12 years or over on the day of the ride
Donation
Optional donation to Singleton Neighbourhood Centre
Donation amount
How did you hear about the ride?
How did you hear about the ride?*
Total
Total
$ 0.00
Payment by Credit Card
Credit Card

MasterCard
Visa
Card Number Expiration Date Security Code Cardholder Name
Phone
This field is for validation purposes and should be left unchanged.

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