Thank you for registering for the St Nic's Cycle Ride

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By taking part, you'll be supporting St Nicholas Hospice Care. Your registration fee and subsequent fundraising will help provide essential care and support for patients and their families across West Suffolk and Thetford facing dying, death and grief.

Your ride

Please complete one form per individual. For details about our entry fees and what's included in your registration, please visit our FAQs page.

Your email address*

For confirmation of registration

Enter Email Confirm Email

Please select your ride*

Are you registering an adult or a child?*

Cyclist's details

Title*

Name*

First Last

Email (if different from above)

Enter Email Confirm Email

Phone number*

Address*

House name/number and street Address Line 2 Town County Post Code

Date of birth*

Your child's details

The minimum age for participants is 8 years old. Participants aged between 8 and 17 years of age must be accompanied by an adult at the event at all times. All adults must make the decision whether their under 18 year old is capable of completing the route.

All riders taking part in the event must have either completed a cycling proficiency test or have adequate experience of cycling on public highways.

Child's name*

First Last

Child's date of birth*

Parent / Guardian's name*

First Last

Parent / Guardian's phone number*

Parent / Guardian's address*

House name/number and street Address Line 2 Town County Post Code

Your data

Knowing how and why St Nicholas Hospice Care uses your data

So you can hear how your support makes a difference and learn of other ways to get involved, you may receive telephone contact and post on news, events, and fundraising.

Would you like to hear from us by email and SMS? Please tick the following boxes to opt-in.

If you’d like to amend how we contact you, please visit our website: www.stnicholashospice.org.uk/yourdata or phone: 01284 715566.

Email*

Yes
No

SMS*

Yes
No

For your safety

Emergency contact's name*

Your emergency contact must be someone not on the ride with you.

First Last

Emergency contact's telephone number*

Are there any medical conditions we should be aware of?

Your story

We'd love to know why you have chosen to take part in the St Nic's Cycle Ride in aid of the Hospice. Please share your story below.

Are you happy if we use your story or testimony in our marketing to promote St Nic's?

Yes

Helping us

Have you taken part in any cycling events organised by St Nicholas Hospice Care before?*

Yes
No

Why have you chosen to sign up for the St Nic’s Cycle Ride?*

To support St Nicholas Hospice Care
To have a family day out
To improve fitness
In memory of a loved one
To achieve a personal goal

How did you hear about the event?*

Newspaper
Email
St Nicholas Hospice Care website
Social media
Word of mouth
Leaflet/poster

Which social media platform?*

Add a donation to your registration fee

St Nicholas Hospice Care relies on the generosity of our supporters to fund much-needed services for people living with dying, death and grief. If you are able, please consider making a donation today so that we can continue providing care throughout West Suffolk and Thetford.

• £5 could support a young child working through their grief with craft materials for Nicky's Way, our child bereavement service.

• £10 could provide comforting meals to patients on our Sylvan Ward, ensuring they receive a nutritious meal.

• £15 could provide treatment products to be used in our complementary therapy sessions, providing a relaxing experience for our patients.

How much would you like to donate?

Gift Aid: Boost your donation by 25p of Gift Aid for every £1 you donate
Gift Aid is reclaimed by the charity from the tax you pay for the current tax year. Your address is needed to identify you as a current UK taxpayer.

In order to Gift Aid your donation you must tick the yes box below:*

In order to Gift Aid your donation you must tick the yes box below:

No

Please notify the charity if you:

- want to cancel this declaration

- change your name or home address

- no longer pay sufficient tax on your income and/or capital gains

If you pay Income Tax at the higher or additional rate and want to receive the additional tax relief due to you, you must include all your Gift Aid donations on your Self-Assessment tax return or ask HM Revenue and Customs to adjust your tax code.

Payment

Declaration / Terms and conditions*
Your health is your responsibility. We respect your personal judgment regarding your fitness levels and readiness to take part in this event.
However, for your safety and the safety of all participants, please consider the following:
• Do not push yourself beyond your capabilities.
• If you have known medical conditions that may affect your ability to cycle this distance safely, consult a medical professional before participating.
• Please ensure any medical conditions are stated in your registration form
• If you feel unwell before, during, or after the St Nic's Cycle Ride, please inform Event First Aid for assistance.
By ticking the box, you confirm that you have read and understood this statement and the event Terms and Conditions and will only participate if you deem yourself fully fit to do so. Your safety is our priority.
I confirm that I have read the Fit to Participate Declaration and I agree to the terms and conditions of entry

Total
£ 0.00

Click submit to enter your payment details.

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Phone
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Thank you for registering for the St Nic’s Cycle Ride

Your ride

Cyclist's details

Your child's details

Your data

For your safety

Your story

Helping us

Add a donation to your registration fee

Payment

Want to hear more from St Nic's?