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Bristol to Swansea Cycle Provisional Booking Form

Provisionally book your place in the Southmead Hospital Charity Bristol to Swansea Cycle

Name(Required)
DD slash MM slash YYYY
Address(Required)
I am medically fit enough to take part in this cycle challenge (please consult your doctor if you have any concerns).(Required)
How would you like to fund your cycle?(Required)
Are you happy for any photos taken on the day to be shared online and in print by Southmead Hospital Charit and North Bristol NHS Trust?(Required)
I confirm that I am aware the Bristol to Swansea Cycle is a fundraising event and I am committed to raising a minimum of £500 (excluding gift aid) for Southmead Hospital Charity. If I have not raised £500 by 5 November 2025, I understand that I may be required to pay the full cost of my place (£350) if I have not done so already.(Required)

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Thank you for your support – it makes a huge difference to our patients, their families and our staff.

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