This form can no longer be submitted as the cashback program has closed.
ACC may modify the terms and conditions of the pilot without any notice.
At ACC, we are committed to protecting your privacy. We will collect and use your details only for the purpose of the pilot.
ACC may use your personal information provided to contact you to ask you to provide feedback via a survey.
ACC is not responsible for any incorrect submissions or inaccurate information provided during submission, nor is ACC liable for any technical or human error which may occur during the administration of this pilot.
Subject to any applicable law which cannot be excluded, ACC and their employees are not responsible for any loss or damage whatsoever that may be suffered (including while taking part in Ride Forever coaching).
Any complaint must be sent to firstname.lastname@example.org. A response can be expected within 48 hours.