2026 Pedal4Prostate

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Kickstart Fundraising

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Personal Details

First Name *

Last Name *

Email Address *

Password *

Phone *

Date of birth *

Gender *

Male Female Other

I'd like to receive communications from Prostate Cancer Foundation NZ keeping me informed of how my efforts are helping them make a difference for Kiwi men and their families.

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Emergency Contact Details

Please provide us with an emergency contact

First Name *

Last Name *

Contact Number *

Relationship to you

Additional Questions

Lunch is included with your registration. Please indicate if you need a Gluten Free or Vegan option. *

Additional lunches for your supporters are available in the shop, $20.00 incl. GST

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What is your primary motivation for joining the ride this year? *

How did you hear about this event? *

By registering for Pedal4Prostate you will receive event-specific communications.

Parental Consent

As the parent or Legal Guardian of the person completing this registration (who is under the age of 18), I confirm I have read and understood the Terms & Conditions and consent to my Child participating in Pedal4Prostate (the Event). I have added my personal contact information in the following field.

Parent / Legal Guardian Details

Terms & Conditions *

I agree to the Pedal4Prostate Terms & Conditions.

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Personal Details

Emergency Contact Details

Additional Questions