London to Brighton Bike Ride 2004


You can pay by cheque:
. Send a note of your requirements and a cheque for the full amount made payable to T.Martin  to:
"Woodlands Cottage" Braintree Road  Wethersfield  Essex CM7 4AG


Or

 Credit Card:
(All details are submitted securely)


 Fields marked * must be completed

                                 

Tee Shirt (small) 

Tee Shirt  (medium) 

Tee Shirt  (large) 

Tee Shirt  (xl)    


All at £7.00 each





Barbecue on the Beach

At £10 per head



Coach (Rider & Bike) back to London

At  £18 per head




         

 

Don't forget Tee Shirts are compulsory!

 

 

Any other comments/requirements

 

Your mobile phone number ( for use on the day)

*Card Type

*Card Number

*Valid From

*Expiry Date

Issue Number or Start Date

*Name (as it appears on card)

*E-MailAddress:

 

 

 

 

 

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