* 2. Ride date:

Please enter date format as shown:

* 3. Number of people on ride (exclusive of leaders):

* 5. Full names of participants (one name per line):

Thank you for reporting Breeze Rides. Cycling Victoria uses ride data for the following purposes:

1. To analyse trends associated with Breeze Rides and provide feedback to leaders
2. To provide evidence of ride participation to current and potential program sponsors
3. To ensure we know that you are an active Breeze Leader

If you have any questions please contact Breeze Liaison Simone Evans on (03) 8480 3077 or at simone.evans@cycling.org.au.