Bridge to Bridge Challenge 2027

Your Name *

Date of Birth *

Address *

Phone Number *

Email Address *

Gender

MaleFemaleOtherPrefer not to say

Type of Rider

New to cyclingUnder 14 miles an hour14-16 miles an hour16-18 miles an hour18+ miles an hour

Have you had your bike serviced before the event? We strongly advise your bike is serviced 2-3 weeks before the event.

YesNo

What is the make and model of your bike? *

Which ride option

One day rideTwo day ride

Rider Hoodie Size

SmallMediumLargeXLXXLXXXL

Please list any medical conditions

Please list any medications you take

Do you have any allergies (e.g. bee stings, food, medication)?

Do you wear a medical alert tag or carry emergency medication?

Emergency Contact

Name *

Relationship *

Phone Number *

Alternate Phone Number *

Acknowledgement of Risk and Assumption of Responsibility

I, the undersigned, acknowledge that I am voluntarily participating in a self-supported 212-mile cycle ride from Severn Bridge to Humber Bridge. I understand that this is a physically demanding endurance event that carries inherent risks, including (but not limited to): physical exertion, adverse weather, road traffic, mechanical failure, injury, and the potential for accidents.

I confirm that I am physically fit, adequately prepared, and solely responsible for ensuring that both I and my equipment are suitable for this challenge. I accept full personal responsibility for any risks, injuries, or damages I may sustain as a result of my participation.

Insurance Declaration

I confirm that I have valid and appropriate personal cycling insurance in place that covers me for this event, including but not limited to: personal injury, third-party liability, and damage to bicycle.

I understand that event organisers and affiliated parties do not provide any insurance cover for individual riders and that it is solely my responsibility to ensure I have adequate coverage in place prior to the ride.

Waiver and Release of Liability

In consideration of being permitted to take part in this ride, I hereby fully and forever waive, release, and discharge the event organisers, volunteers, sponsors, supporters, and The Sailors’ Children’s Society (charity) from any and all liability, claims, demands, causes of action, or expenses (including legal fees) arising out of or in connection with my participation in the ride.

I understand that The Sailors’ Children’s Society has no involvement in the organisation, supervision, or insurance of this ride, and accepts no responsibility or liability whatsoever for any injury, loss, damage, or death arising from or related to my participation.

Rider Declaration

By signing below, I confirm that:
• I have read, understood, and voluntarily accept the terms of this waiver.
• I ride entirely at my own risk and accept full responsibility for my health, safety, and conduct during the ride.
• I have personal cycling insurance in place to cover all associated risks.
• I acknowledge that The Sailors’ Children’s Society has no liability in relation to this event.

Print Name *

Date *

By selecting ‘Send’ you agree you’ve read and accepted the above.