Devon Air Ambulance Trust – Entry Form 9th Annual Motorcycle Ride Out - 13 July 2014 Title:
First Name:
Last Name:
Address: Postcode: Tel No (day): d
Tel No (evening):
Mobile No:
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About your bike:
Model:
Make:
Reg:
By entering the Motorcycle Ride out I confirm that (please tick by way of confirmation) : My machine is legal for road use I have a current MOT I have a valid Insurance Certificate and Road Fund Licence I confirm that I am completing this form myself This year the starting location will be: Heathcoat Cricket Club, Knightshayes, Tiverton, Devon, EX157RQ I would like to make a further donation to the charity of
Please tick here if you are a UK taxpayer
£
If you are a UK taxpayer Gift Aid can make your donation worth even more. For every pound you give, the charity will receive an extra 25 pence from the Inland Revenue. If you would like to Gift Aid your donation please tick here Note: To Gift Aid this donation you need to confirm that you are a UK taxpayer and pay an amount of Income Tax and/or Captial Gains Tax at least equal to the tax that can be reclaimed on this donation. How did you hear about this event? T-Shirt Size: (Please circle required size) SMALL
MEDIUM
LARGE
X LARGE
XX LARGE
TERMS, INDEMNITY AND INFORMATION By signing this form I confirm that I have read and agree to the terms, indemnity and information set out below Date:
Signed:
Please now return this form with your minimum donation of £5 (cost per bike) cheque made payable to Devon Air Ambulance Trust to DAAT, 5 Sandpiper Court, Harrington Lane, Exeter, EX4 8NS. Closing date: pre entries 8 July 2014 If you wish to pay on the day payment is by cash only and entry on the day does not include a t/shirt By entering to take part in the DAAT Motorcycle Ride Out I confirm and accept the following terms: The DAAT Ride Out is organised by Devon Air Ambulance Trust. The DAAT Ride Out will start from the above mentioned venue. Each entry for the ride will only be accepted if this form is completed in full and is accompanied by the correct fee. Entry is by a minimum donation of £5, on the day entries will be accepted by cash only and will not include a T-shirt. The first bikes will depart at 11am. You are required to arrive by 9.30am to allow yourself sufficient time to register. The route will be marshaled from start to finish. Devon Air Ambulance Trust reserves the right to change any part of this event should circumstances beyond their control dictate.
Breakdown vehicles will be provided – recovery by the breakdown vehicles is for bike, rider and pillion to The Den, Teignmouth only. Further transport by mutual arrangements with the driver. Participants enter at their own risk. You will receive a souvenir T-Shirt at the start. Additional T-Shirts can be purchased for £5 at the finish point ( subject to availability).
Ride Out Cancellation If the event is unable to take place due to unforeseen circumstances the organisers will be entitled to cancel the event. In such circumstances we will try to let you know in writing of the cancellation. In the event of cancellation your entry fee is non refundable and the event organisers will accept no other liability to you for any costs or expenses you may incur as a result of the cancellation. If you would like to help even further why not consider being sponsored – we can provide sponsor forms or set up your own online page at www.justgiving.com