London to Paris Cycle for Back Up 2025 : 26/09/2025 - 29/09/2025

Step 1 of 4: Personal Details » Medical Details » Summary » Payment

Personal Details

Please can you tick the box if you have been on a trip with us before

Title:

First Name *:

As it appears in your passport

Last name *:

As it appears in your passport

Gender *:

Shared accommodation is standard. We may contact you privately to discuss your room share options. Please use the Room Share Request field in the portal if required.

Gender description:

Date of birth *:

dd/mm/yyyy (under 18?)

Postcode *:

Address Line 1 *:

Address Line 2:

Address Line 3:

Town/City *:

County:

Country *:

State:

Mobile Phone *:

Home Phone:

Work Phone:

E-mail Address *:

Please re-type E-mail Address *:

Data Protection

Back Up Trust will not pass on your details to any other organisation apart from Discover Adventure Ltd who will only use them for purposes of administering this event in accordance with their Privacy Policy. By submitting this form you agree to Back Up Trust or Discover Adventure contacting you about this challenge.

Back Up Trust would like to keep you informed about the charity; particularly about their services and other ways you can help, including opportunities to donate, volunteer or fundraise. If you would like to receive further information about us, please indicate below how you would prefer to be contacted:

Phone

Text

Post

Where did you hear about this Challenge? *:

Please give more detail where possible:

Would you like PRE-NIGHT ACCOMMODATION? fee to be confirmed

Would you like SINGLE ROOM SUPPLEMENT? Fee to be confirmed

Would you like to have your bike couriered to your home address for a fee of £99? If yes, we will email the form for you to complete

By clicking Next you agree to Discover Adventure Ltd contacting you about this challenge.