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The Great North
Bike Ride ©
Sunday
29h August 2010
Entrants name: ......................... ..................................
Address:
....
..
...............................................................................................................................
................ .... Postcode: ... Daytime telephone: ..Email address: ................. .. Emergency Contact Name: .. Emergency Contact Number: ..
Please
reserve my entry in the 2010 Great North Bike Ride at £12
Registration including Bike Breakdown Service,
Medal & Nike T-Shirt £12 per person
(All
our arrangements include this service which, (apart from minor repairs
and punctures), gives you the peace of mind, that, if we are unable to
repair damage to your bike along the route help is at hand; I enclose a cheque for the sum of £ made payable to: Chris Lucas Trust including Bike Breakdown Service (Please enclose a A5 large letter stamped addressed envelope). Or Please reserve my entry in the 2010 Great North Bike Ride at £10 Registration Medal & Nike T-Shirt, NOT including Bike Breakdown Service, Please note if you decide not to take the Bike Breakdown Service if you breakdown or cannot finish the ride you will need to make your own arrangement to take you and your bike to the finish line at Tynemouth. ( Please enclose a A5 large letter stamped addressed envelope). I enclose a cheque for the sum of £ made payable to: Chris Lucas Trust NOT including Bike Breakdown Service (Please enclose a A5 large letter stamped addressed envelope). I do / do not wish to be kept on the Great North Bike Ride charity database. I do / do not wish to be updated periodically with event information. 1. I undertake to be bound by the Great North Bike Ride event rules, which are available on request or at www.chrislucastrust.com 2. I understand that Chris Lucas Trust cannot be held responsible in any way for loss or injury to myself or any other party, howsoever arising. 3. I understand that I have a legal responsibility to ensure all sponsorship money, received by me are paid to Chris Lucas Trust before 31st October 2010. Using Gift Aid you can make your donation /entry fee worth more. For ever pound you give us, we get an extra 28 pence from the Inland Revenue, helping your donation go further. This means that £10 can be turned into £12.80. So just tick here □ I want all donations Ive made since 6 April 2000 and all donations in the future to be Gift Aid until I notify you otherwise. To qualify for Gift Aid, what you pay in income tax or capital gains tax must at least equal the amount Signed: ....... Print Name: .. Date: ........... Where did you see the advertisement? ..................................................................... Thank you for your co-operation, we look forward to seeing you at the event!
Please Return to: Chris Lucas Trust, 95,
Lancaster Drive, Hadrian
Park, Wallsend, North Tyneside, NE28 9TF |
