If you are applying to cycle for VICTA in RideLondon-Surrey 100 as part of a team of four, please complete the following application form.

Please note, each member of your team will need to complete this form.

Apply to cycle for VICTA in the 2018 RideLondon-Surrey 100 - Team Entry

Fields marked with a * are mandatory.

Please note, once you have successfully submitted the form it will clear and be replaced with a success message. You should also receive a confirmation email. If you do not you may not have completed all the required fields. Please check back through the form and make sure you have completed each question marked with a *.

Section One - Applicant Details

Section Two - Team Entry Details

Section Three - Cycling History

Section Four - Team VICTA Details

Terms and Conditions

1. You confirm that the information on this form is complete and correct at time of submission.

2. I declare that I will use a permitted, roadworthy bicycle in the sportive as per RideLondon guidelines.

3. I declare that I will abide by the Laws and Rules for competition of British Cycling, that I will be 18 years or over on 29 July 2018, that I will compete by human powered cycle and that my entry is subject to the General Conditions of Entry a copy of which is on the RideLondon website.

4. You must complete the pledge in Section 3 of the application form, entering £375.00 or more in the space provided.

5. Should you be accepted, you agree to pay a non-refundable registration fee of £25.00. This fee falls due upon your acceptance of our VICTA charity place and must be received by the VICTA office within one calendar month of that date unless otherwise stated, together with your signed legal agreement. Your team must also have established a group Virgin Money Giving page for the event to allow for joint fundraising.

6. If allocated a Charity Bond place, you are pledging to raise your selected amount and agreeing to make up any shortfall yourself to the required minimum of £375.00 (excluding Gift Aid) by the 3 September 2018.

7. All applications are subject to a selection process to ensure that charity places are used to best possible effect (at the discretion of VICTA).

8. If allocated a VICTA Charity Bond place you agree to inform VICTA as soon as possible in writing should you become unable to take part in the 2018 Prudential RideLondon-Surrey 100, at which point your minimum sponsorship obligation will cease.

9. You understand that should you withdraw from your VICTA charity place the registration fee is non-refundable and will be retained to cover expenses.

10. If allocated a place, you agree that images taken on the day may be used by VICTA to help promote our fundraising efforts.

11. If you are unable to participate in the 2018 Prudential RideLondon-Surrey 100 for any reason all donated monies collected in support of VICTA must be forwarded to VICTA or returned to the individual sponsors.

12. All participants enter at their own risk in accordance with the Prudential RideLondon-Surrey 100 regulations.

13. You understand that, should you be accepted to cycle for VICTA, you will be required to also fill in the Official Prudential RideLondon-Surrey 100 online entry system before it closes. Failure to do so will result in you not being allowed to take part. As this will be done electronically via the Prudential Ride London-Surrey website, you understand you will need to have internet access and access to an email address at some point before this date.

Please make sure the form clears and is replaced by a success message. You should also receive an automatic confirmation email. If you do not receive this your form will not have gone through correctly and you will need to check you have completed all of the required fields.