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Big Wheel Bike Ride
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- 3/14/2010
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- English
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Document Sample
St. Michael’s Hospice
Annual Sponsored Bike Ride raising funds
Big Wheel Bike Ride
for St. Michael’s Hospice (North Hampshire). ENTRY FORM
Registered charity no. 1002856
Sunday 20th July 2008 Sunday 20th July 2008
An exciting & enjoyable day for all the family Start time: 9.00am - 10.30am
Starts and finishes: Down Grange Sports
45 miles: start at 9.00am Complex, Pack Lane, Basingstoke
24 miles: start at 9.30am To qualify for one of the top fundraiser prizes, please
have your sponsorship forms in by 10th October
<7 miles: start at 10.00am
Choice of routes:
• < 7 miles
FREE training rides with the North • 24 miles
Hampshire Road Club • 45 miles
Prices:
Delicious refreshments, music, and • Adult £12.00
massage for those aching limbs! • Children £6.00
• Family £30.00
• Tandem £20.00
First Aid teams, pick-up support Prizes:
vehicles, clearly signed and 1st 6 months single membership
marshalled routes to Basingstoke Sports Centre
2nd Mountain Bike courtesy
of Action Bikes £200
3rd Sony PS2
HOTLINE:
01256 848 848
Email: bigwheel@stmichaelshospice.org.uk
Website: www.stmichaelshospice.org.uk
HOTLINE:
Sponsored by
01256 Sponsored by
848 848
If the event is not for you,
please pass this leaflet on Email: bigwheel@stmichaelshospice.org.uk
to a keen cyclist. Thank you. Website: www.stmichaelshospice.org.uk
starts are staggered between 9:00am - 10:30am.
Our sponsored annual bike ride is the largest
T-shirts
Services Prizes
event in the Hospice’s calendar. In 2007 1100 100% pure cotton
(Limited stock may vary in design & colour)
St. Michael’s Hospice provides: riders raised £30,000 in profit for the Hospice, ● 1st - 6 months single memebrship to
• In-Patient Care • Day Care • Community so why not come along and help us exceed this. Please indicate quantity
Basingstoke Sports Centre and sizes:
Nursing Service • Out-Patient Clinics Cycling is a perfect way to keep healthy, ● 2nd - Mountain Bike courtesy of Action
An holistic approach is fundamental to the care de-stress and provide you with more zest for Bikes £200 Child £6.50
the Hospice offers and Hospice staff work as a life. If you haven’t been on a bike for a while, ● 3rd - Sony PS2 ● 5-6 ● 7-8 ● 9-10 ● 11-12
multi-professional team which includes: don’t worry as the North Hampshire Road
Adult £9.50
• Nursing and Medical Staff Club are on hand to ease you back into the
• Occupational Therapist • Physiotherapist saddle with free training rides taking place each Entry Form ● Sml ● Med ● Lrg ● X-Lrg
• Complementary Therapists • Chaplaincy Monday evening starting on the 12 th May. Fitted Tee £10.50
• Family Support • Bereavement Support Please use one form per cyclist unless
All three rides start and finish at the Down ● S-M ● M-L ● XL
This year it costs around £2 million to fund Grange Sports Complex, Basingstoke where entering as a family residing at the same
St. Michael’s Hospice, 32% comes from the can enjoy free parking and amazing free address. Photocopies are accepted, Please add post & packaging at 50p per t-shirt
government, and the remaining £1.3 million entertainment. This includes fun and games or forms can be downloaded from
must be generated through fundraising from the Circus Works team with activities www.stmichaelshospice.org.uk. I enclose Registration Fee £ . . . . . . . . . . . . .
activities and the Hospice charity shops. such as plate spinning, juggling and parachute Please note you can register and pay online. Adult £12 , Child (16 and under) £6 ,
games and the largest Giraffe bouncy castle Name . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Family Ticket (2 adults and 2 children) £30,
Here are some examples of current Hospice costs in Basingstoke, donated by JV Bouncy Tandem £20
which your sponsorship could contibute towards: Address . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Castle hire. Riders can enjoy an incredibly
• One day In-Patient Care – £2,300 .................................................. Donation £.............
relaxing free leg massage from our team of
• One week for the team of Community Nurses T-Shirt + P&P £.............
Complementary Therapists. Delicious food and . . . . . . . . . . . . . . . . Postcode . . . . . . . . . . . . . . . . . . . . . . .
who go out to patients’ homes – £2,000
• Catering at St. Michael’s Hospice per week drink to suit everyone is also available. Tel (Day) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . I am a Tax Payer and wish
– £391 Tel (Evening). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . to Gift Aid my donation
• Physiotherapy per day – £70 Credit/Debit Card Payments Email . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Total Payment £.............
• Occupational Therapy per day – £65
• A uniform for a St. Michael’s Hospice Name of additional riders in family group How did you hear about the event?
Community Nurse – £40 Visa Mastercard Maestro living at the same address.
• Community transport to take Day Care Card No. .........................................
patients out for the day – £20-50 Name . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Conditions
• A litre of base cream to make aromatherapy Relationship to main rider . . . . . . . . . . . . . . . . . . . . . . . Riders aged 16 and under must be accompanied by
oils – £10 an adult over the age of 18. I understand that this event
Valid Date / Signature . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
is not a race and all riders must obey the Highway Code
A Fantastic Day Out for Date . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . and the Rules of the Road. Cycling can be a dangerous
Expiry Date /
I have read and agree to the conditions stated below. (To be activity and I accept that the organisers cannot be held
all the Family signed by parent or guardian if rider is aged 16 or under). responsible for personal injury, accident, loss, damage
Issue No 3 Digit Security No or public liability. I have read and agree to the above
Why not lend your support by spending (Only found on Maestro Cards). Name . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
conditions. I am happy for any photos of me at the
a glorious summer’s day riding through the Please debit my card to the value of £ Relationship to main rider . . . . . . . . . . . . . . . . . . . . . . . event to be used for promotional purposes of the event.
beautiful countryside of North Hampshire to Signature . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
raise much needed funds for your local Hospice. Signature . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
We invite you to join us on Sunday 20th July for
Signature Date
Date . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Date . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Big Wheel 14 sponsored by Alberto-Culver and
The event entry fee goes towards the cost of staging Big Wheel 14 so we Route Please complete and return with payment to
enjoy one of our three breathtaking routes of St. Michael’s Hospice (cheques made payable
encourage you to get sponsored. A fantastic prize is available to each of the Please indicate intended route by ticking box below
<7 miles, 24 miles and a truly testing 45 miles top three fundraisers so please ask friends, family, work colleagues (many to St. Michael’s Hospice)
(designed for regular cyclists or those undertaking companies match employees fundraising), and your local gym, because every ● Short < 7 miles ● Medium 24 miles
Big Wheel 14, St. Michael’s Hospice, Basil de Ferranti
training). Each route has refreshment stops and penny raised really does make a difference. ● Long 45 miles House, Aldermaston Road, Basingstoke RG24 9NB
Hotline: 01256 848 848 E-mail: bigwheel@stmichaelshospice.org.uk Please note you can register and pay online
www.stmichaelshospice.org.uk
