The Great North Bike Ride © Sunday 24th August 2008

Contact name: ….........................…………………………………..................................

Address: …………....……..…………………………………………...............................................................................................................................

................…....………………………………………………Postcode: … … … ... … … …

Daytime telephone: ……………………………………..Email address: ………….................………………………………..

Please reserve my entry in the 2008 Great North Bike Ride at £10. ( Please enclose a A5 stamped addressed envelope).

I enclose a cheque for the sum of £ …………made payable to: Chris Lucas Trust

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 2008.

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 I’ve 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