The Kingspan IHF Wild Mediterranean Way Cycle Challenge 2016 Brochure

The Irish Hospice Foundation

CYCLE E G N E L L CHA

y a W n a e n a r r e iT d e M d The Wil th th June 2016 24 ay id Fr to 18 ay rd Satu

Join us for the challenge of a lifetime by cycling from Canet-en-Roussillon, France to Barcelona, Spain along the beautiful coastline and via the spectacular Pyrenees.

N IO T A D N U O F E IC P S O H H IS IR TH E 6 1 0 2 E G N E L L A H C E L C Y C join The irish hospice enlist the help of two wheels and of a lifetime and take Foundation (ihF) for the challenge Way Cycle Challenge. on our 2016 Wild Mediterranean Travel from Canet-en-Roussillon to Barcelona along the Mediterranean coast while taking in all that The Med has to offer. The cycle route starts in Southern France and moves through Roussillon and further on to the foothills of the Pyrenees and beyond to the Catalan Capital Barcelona!

Cyclists of all levels welcome We welcome cyclists of all levels on our trip and do this by offering two routes on many days, so the advanced cyclist can tackle some extra climbs in Baixa Garrotxa and Montenegre while others can continue on with the challenge.

The Challenge You will be cycling over 600km (incl. climbs) or 540km (ex. climbs) over the five days, while raising vital funds for The Irish Hospice Foundation.

There will be options along the way so that those who are keen and capable cyclists can tackle the Coll Formic and take on the Sant Hilari Sacalm, before we arrive into our final destination – the Capital of Catalunya, Barcelona.

Trip Summary Departing from Dublin on Saturday 18th June, we travel to our hotel in Canet-Plage. The following morning we will begin the first of five days cycling through the picturesque towns and villages, before spending our first night in Roses – a town rich in Greek and Roman history.

Following on from here we head inland towards the Pyrenees through the Baixa Garrotxa volcanic zone! We exit the Baixa Garrotxa toward the optional climb of Sant Hilari Sacalm and move down the coastline toward Calella with its 3 blue flag beaches where we’ll be spending the night. Our last day sees us riding through the Parc Natural de Montenegre before reaching the coast again and riding along the famous 4km Barcelona Beach.

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a bit about Cycling Safaris We enlist the help of the fantastic team at Cycling Safaris to plan our route and manage all aspects of our cycle for the entire duration of the trip.

Cycling Safaris have been organising bike tours in the west coast of Ireland since 1989.

Since then they have expanded their cycling holidays to cover the length and breadth of Ireland as well as numerous locations all over Europe. The Irish Hospice Foundation has been working with Cycling Safaris from the beginning of our annual cycling challenges back in 2009. This cycle will be our 11th adventure with them and we are delighted to have them on the team again!

ITINERARY DAY 1

SAT JUNE 18

DUBLIN TO CANET-EN-ROUSSILLON

We set off from dublin airport for our morning flight to Girona. On arrival, we will be collected and transferred by coach to our hotel in Canet-enRoussillon. You will be reunited with your bike at the hotel as all bikes will have been shipped from Dublin by Cycling Safaris. You’ll take in the long sandy beaches here which have a lovely atmosphere provided by the backdrop of the Pyrenees.

There are also plenty of shops, bars and restaurants keeping this town buzzing.

DAY 2

SUN JUNE 19

CANET-EN-ROUSSILLON TO ROSES 107KM

The first day of cycling begins with a nice gentle warm up along the coast line for 15km to the beautiful town of Collioure.

From here we head inland and climb for almost 10km on a small quiet road that affords wonderful views of the surrounding countryside and the ocean. We then rejoin the coast road and cross the border into Spain.

This is a stunning ride with many great vantage points as the road twists and turns and rises and falls following the coastline. The Cap de Creus peninsula provides some further undulating territory with some unspoilt scenery together with Cadaques, long associated with painter Salvador Dali. Roses is our destination for tonight which has a rich Greek and Roman history, but today it’s a modern town attracting visitors for its beaches and restaurants.

DAY 3

MON JUNE 20

ROSES TO OLOT 110KM

The second morning sees us leaving the coast as we head inland towards the Pyrenees. As we pass the town of Figueres the road offers a great surface and very little traffic as it gently climbs passing medieval towns and villages. The wonderful medieval town of Besalu with its 12th Century Romanesque bridge and arcaded streets is a perfect stopping point for lunch. The route then leads us into the Baixa Garrotxa Volcanic Zone! There around 30 “cones” from extinct volcanos reside and are home to unique flora and fauna. Olot is a town of intimate squares, elegant shops and welcoming bars in the heart of the volcanic zone.

DAY 4

TUE JUNE 21

OLOT TO SANT FELIU DE GUIXOLS 119KM

After an initial short climb out of the town, we enjoy the most tranquil day of our trip with a long descent across the Baixa Garrotxa. Santa Pau, an atmospheric medieval village in the heart of this region will make for a worthwhile short break. We then skirt the edge of Lake Banyoles, the largest natural lake in Catalan with a magnificent backdrop of the mountains. The Gavarres massif offers a lovely quiet road and some extra climbing opportunities for those who want them (such as the Sant Marti de Romanya or Coll de la Ganga). Soon the coast comes back into view and our destination Sant Feliu de Guixols can be spotted. It has a beautiful sandy beach backed by a glorious tree lined avenue leading from the rocky headland to the south. The traffic free Rambla Vidal is a great place to shop, eat and people watch.

DAY 5

WED JUNE 22

SANT FELIU TO CALELLA 103KM

The coast road from Sant Feliu again offers wonderful riding as it exhibits great views at every corner and is a particularly unspoilt section of coastline. We then head inland into the Parc Natural de Montnegre (Black Mountain) to escape some of the busier coastal resorts. Another optional climb here is the Sant Hilari Sacalm, which is almost 21km long but a very reasonable average of 3.2%. Soon we come back down to the coast and our destination Calella with its 3 blue flag beaches awaits.

DAY 6

THU JUNE 23

CALELLA TO BARCELONA 102KM

Our last day sees us venture inland again to the Parc Natural de Montnegre to avoid the busy coastal road. Here we offer another optional climb with the Coll Formic that goes into the heart of the Montseny National Park, a UNESCO biosphere reserve (22km long, 920m Gain, 4% average). Our entry into Barcelona follows a great riverside bike path for several kms before heading along the coast and passing the famous 4km beach to reach our finish! We no doubt will dip our toes in the cooling Mediterranean sea as we celebrate how we conquered the Wild Mediterranean Way!

DAY 7

FRI JUNE 24

BARCELONA TO DUBLIN

After a wonderful celebratory evening the night before you will have time to explore the city of Barcelona before we make our short transfer to Barcelona El Pratt Airport for our return flight to Dublin. *Flight details to follow.

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HOW DO I SIG N U P? The total participation fee is €2,990 for the Wild Mediterranean Way Cycle Challenge.

This fee can only be guaranteed for participants that register and pay their registration fee by Friday 18th March 2016. (An additional cost may occur after this date due to the fluctuation of flight & accommodation costs) The total participation fee of €2,990 is split into two elements: n Tour cost of €1,050. n Sponsorship of €1,940.

The tour cost of €1,050 must be paid as follows: n Registration fee of €250 on sign-up. n Balance of €800 due 21 days after receipt of registration fee. *note tour cost of €1,050 can only be guaranteed up to 18th March 2016.

The sponsorship of €1,940 must be paid: n First payment of €975 due 1st May 2016. n Second payment of €965 due 31st May 2016.

inFOrMaTiOn WeeKend An Information Weekend will take place in May 2016, and is an opportunity to meet the IHF and Cycling Safaris team as well as other participants.

We can answer any queries you may have, give you advice on equipment and training and give you additional information about the trip. We will also have a modest cycle on this day. This is a really useful day to pick up tips and advice on the route, training and your fundraising. We strongly encourage you to come to the Information Weekend as it provides an important and valuable opportunity to discuss all matters of the cycle. This is a great chance to get well acquainted with everyone involved in the cycle and an opportunity to gauge your fitness levels! All presentations from the day will be made available to everyone after the weekend, however this does not replace the value of being there in person.

Pre TriP BrieFinG

discounted rates:

introduce a Friend or Sign up as a Team!

Avail of our sponsorship discount* by referring a friend or by signing up as a team of 4 or more. Your sponsorship total will be reduced by €250.

A detailed pre trip briefing will be sent out to participant’s approximately one month before departure with all the necessary details including travel arrangements.

“I hope you will join this wonderful trip that raises important funds for such a worthy cause. I look forward to seeing old friends and making new ones as we travel across France and Spain”.

Paul Kimmage Journalist & former professional cyclist

* This discount offer is only available to participants who introduce a friend who has never participated in the Kingspan IHF Cycling Challenge or Teams of 4 or more (this can include previous participants) who sign-up together.

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Find out the difference you can make in one week…

The irish hospice Foundation (ihF) is a national charity striving for the best care at end of life.

Reaching every county in Ireland, we are bringing hospice care and principles to adults, children and families where and when they are needed. We receive NO core state funding and rely upon voluntary funds – like those raised through this cycle challenge – to maintain our work.

Once again, the money raised through the cycle challenge will help our Nurses For Night Care service – which provides free night-time nursing care in the home for those at end of life. The nurse stays in the home through the night providing nursing care, practical support and reassurance to the person with a life limiting condition and valuable respite for family members.

2016 marks the 10th anniversary of Nurses for Night Care and over the last decade the service has experienced huge growth. When it began in 2006 we provided around 100 nights of nursing care. In 2015 this increased to over 1,500 nights of care and we expect this figure to rise again in 2016.

A survey carried out by the IHF in 2014 revealed that 74% of people want to die at home, but only 26% get to do so. With your

help we are trying to support more people to spend their final days at home in their own bed, with their family by their side.

Cyclists who have raised funds over the years have played a major role in making this a reality. We hope that you will continue to be a fundamental part of the funding for this vital service by signing up to participate in our Wild Mediterranean Way Cycle Challenge. Each day spent in the saddle will mean at least one night of comfort and nursing care for those nearing the end of life. The minimum amount raised by each cyclist (after costs) equates to 6 nights of care. One week really does a make a difference to those at a very vulnerable time of life, end of life.

For more information on the work of The Irish Hospice Foundation call us on 01 6793188.

When it began in 2006 we provided around 100 nights of nursing care. in 2015 this increased to over 1,500 nights of care and we expect this figure to rise again in 2016.

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QU IC K

FACTS n SECURING YOUR PLACE To secure your place you will need to: • Fill in and return the enclosed registration form by 18th March 2016.

• Pay your €250 non-refundable registration fee. You can do this using the form enclosed.

• No travel arrangements will be made until the full Tour Cost of €1,050 is paid.

Registrations taken after the 18th March 2016 may incur extra costs. This will be made clear to participants in advance of registration.

n SPONSORSHIP TARGETS & DEADLINES Total Participation Fee: €2,990

n Deadline 1: Pay registration fee – €250.

n Deadline 2: Pay balance of tour cost – €800, 14 days after receipt of the application form and registration fee to secure your place on the trip.

N.B. No travel arrangements will be made for you until the balance of the tour cost is paid.

n Deadline 3: 1st May 2016. You must raise and pay €975 by this date.

n Deadline 4: 31st May 2016. By this date you must have raised and paid a further €965, bringing your total Participation Fee €2,990, otherwise you jeopardise your place on the trip.

n FUNDRAISING SUPPORT

The team of professional fundraisers at the IHF will provide you with fundraising support including: • Access to fundraising materials and IHF merchandise.

• An online sponsorship account - friends, family and colleagues can sponsor you online through your own personalised web page on www.mycharity.ie or www.idonate.ie • A direct phone number and email address for an IHF fundraiser.

n TRAINING SUPPORT

This cycle crosses the naturally undulating terrain of France and Spain. Although not a flat route we will stick mostly to the

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www.hospicefoundation.ie

if you want to move quickly and guarantee a place, this Quick Facts page contains all of the essential info that you will need to know before signing up. foothills and not seek out any great climbs.

However for the more experienced cyclists and those looking for a greater challenge you can tackle some hillier terrain. It has to be recognised that strong legs and a good cardiovascular fitness are essential - you will be in the saddle for approximately 6 hours a day. We can provide you with the following support to help you train: • Professionally prepared training guide • An information weekend that includes a question and answer session with event staff.

• A list of regular open cycling events to help with your training.

Self motivation is essential!

n SUPPORT TEAM

A support team of several staff and vehicles will organise the ride and be responsible for: • Transporting your bike to France and from Spain.

• Transferring your luggage from hotel to hotel.

• Mechanical support.

• First Aid support.

• Guiding the route.

• Organising water/snack and lunch stops.

n FOOD & ACCOMMODATION

• Accommodation is provided for every night of the trip. It is shared twin rooms in 3H or 4H hotels. Please indicate anyone that you would like to share a room with on your registration form.

Single rooms are available for an additional fee. If you choose to stay on for the weekend in Spain, you will be responsible for organising your own accommodation and flights.

• Water/snack stops. At least 2 stops (one in the morning and one in the afternoon) will be organised on each day of cycling.

Snack stops will consist of energy bars, fruit, and other snacks suitable for cyclists. However if you have particular snacks you eat whilst cycling we recommend you bring them along for yourself.

• Lunch. Lunch stops are organised to take place in Cafes/pubs, consisting of sandwiches/baguettes. As we are stopping in small villages for only brief lunch stops it is not practical to have a hot meal at the lunch stops. Lunch is not provided on day 7.

@irishhospice

• Dinner. On days 1, 2, 3, 4, 5, 6 dinner will be provided to the group either in a local restaurant or in the hotels. On day 7 participants are responsible for buying their own dinner.

• Special dietary requirements. We are only able to accommodate food allergies, specific diets i.e. vegetarian, vegan, and/or religious or medical dietary requirements. Personal preferences cannot be accommodated. Please remember to fill them in on the medical questionnaire that you receive once you have registered. If any individual has particular snack preferences they should consider bringing a quantity with them on the trip.

n TRANSPORT • Flight to Girona on the 18th June and return flight from Barcelona on the 24th June. For those staying on for extra nights you must make your own return flight arrangements.

n WEATHER Cycling at this time of year is usually pleasant and sunny, but you should come prepared for all weathers. Ensure you have packed a waterproof cycling top and sunscreen.

n BIKE INFORMATION You will need to bring your own bike to Cycling Safaris in Dublin approximately 1 week in advance of the trip for it to be transported to France. Please ensure that it has been recently serviced. We will arrange for your bike to be transported safely back to Ireland where it will be available for collection from Cycling Safaris in Dublin.

n WHAT IS NOT INCLUDED? • Travel insurance – mandatory – you must provide us with evidence of your cover. Note: You will not be allowed participate in the trip without Travel insurance.

• Bike insurance • Personal spending money • Lunch and dinner on day 7

irish hospice Foundation

TE R MS AN D CON DITIONS The Kingspan IHF Cycle Challenge Canet-en-Roussillon to Barcelona rules and regulations 1. Anyone taking part in this event are acting as volunteers for The Irish Hospice Foundation and are responsible for and obtaining all necessary permits and permissions in respect of public collections.

GENERAL 2. The Irish Hospice Foundation has appointed Irish Cycling Safaris Ltd (The Company) to organise transport, accommodation, first aid and guides for The Irish Hospice Foundation Cycle Challenge (“the Event”) and accepts no liability for any loss or damages howsoever arising or for cancellation of the Event for any reason.

3. The Irish Hospice Foundation has no control over the organisation and running of the Event and all participants take part at their own risk.

4. The Irish Hospice Foundation has no control over what happens on the Event from the time it departs from Dublin to the time of its return to Dublin. The Irish Hospice Foundation is, therefore, under no liability in contract, negligence, or otherwise for any matter occurring during those dates or for any loss or damage sustained by any participant during those dates. Any complaint must be notified directly to the Irish Cycling Safaris Ltd within 14 days of the end of the Event, in accordance with Irish Cycling Safaris Ltd Booking Conditions below.

REGISTRATION FEES AND DONATIONS 5. To secure your place you will need to: Fill in and return the enclosed registration form by 18th March 2016 along with your €250 non-refundable registration fee.

You will need to pay the balance of Tour Cost, €800, 21 days after receipt of the application form and registration fee to secure your place on the trip. N.B. No travel arrangements will be made for you until the balance of the tour cost is paid. Before 1st May 2016 you must have raised and paid €975 of your Sponsorship balance. By31st May 2016 you must have raised and paid a further €965 bringing your total Participation Fee to €2,990, otherwise you jeopardise your place on the trip.

6. If you are unable to obtain the minimum target amount of sponsorship (€1,940) you are liable to forfeit your place on the Event and your non-refundable registration fee of €250; donations will only be refunded directly to the donor, upon written request by the donor.

7. You must make it clear to all your prospective sponsors that €1,050 of the €2,990 comprises the cost of registration and participation in the Event.

8. Should the Irish Hospice Foundation cancel the Event, the registration fee of €250 will be refundable to you; donations will only be refunded directly to the donor, upon written request by the donor.

9. Should you not be able to take up your place on the Event, donations and registration fees will not be refundable to you; donations will only be refunded directly to the donor, upon written request by the donor.

10. All funds raised in the name of The Irish Hospice Foundation in connection with the Event must be paid as soon as practicable to the Irish Hospice Foundation [in accordance with the method of payment provisions in the attached Application Form].

SAFETY RULES 11. Safety approved cycling helmets are compulsory.

12. You may not deviate from the official route.

13. You are to obey the local traffic regulations, traffic officers and authorised marshals at all times.

14. You may not use your mobile phone or a personal music system while cycling.

IRISH CYCLING SAFARIS LTD BOOKING CONDITIONS 15. Irish Cycling Safaris LTD (The Company) accepts bookings subject to the following conditions: n Passports, Visas Clients are responsible for arranging, and must be in possession of a valid passport and any visa required for the whole of their journey. Information about these matters or related items (climate, clothing, baggage, personal gear etc) is given in good faith but without responsibility on the Company. Clients with a European passport will not need a visa and it is the responsibility of any other passport holders to check with their embassy. n Insurance &Cancellation Insurance Travel insurance is mandatory for all clients whilst on a tour organised by the Company. Clients together with their personal property including baggage are at all times solely at their own risk. Clients are wholly responsible for arranging their own insurance. Clients are responsible for ensuring that they are in possession of private Travel Insurance with protection for the full duration of the tour in respect of at least medical expenses, injury, death, repatriation, cancellation and curtailment, with adequate cover.

Clients should ensure that there are no exclusion clauses limiting protection for the type of activities included in their tour. Clients should satisfy themselves that any travel insurance arranged through the Company is what they require and should arrange supplementary insurance if need be.

Clients will be deemed to have read the insurance cover. n Itinerary While we endeavour to follow our itinerary there may be exceptional circumstances when this is not possible.We reserve the right to cancel or modify the itinerary as necessary. Due to the nature of the trips arrangements have to be planned well in advance, so changes may have to be made and the Company reserves the right to do this. Should a material change be necessary the Company will inform you as soon as reasonably possible. A material change includes, for example, a significant change of destination or route time by more than 12 hours. n Medical Form Prior to the event you will be asked to complete a medical questionnaire. If you are over 60 years of age or if you have any medical condition that could be adversely affected by exercise, particularly a heart condition or asthma, you must provide the Company with a medical certificate from your doctor. By signing this form you are confirming that, to the best of your knowledge, your general state of health is good and that you take full responsibility for your health and personal well being. All medical forms will be independently reviewed by a doctor prior to departure. n Minimum Age Participants must be over the age of 18 on the day of departure. The Company reserves the right to refuse participation to anyone at any time without having to disclose the reason. n Challenge Participation We accept your booking on the understanding that you realise the hazards involved in this type of tour, including injury or death, disease, loss or damage to property, and that you come on the tour at your own risk. We accept no liability for any injury resulting from the hazards of cycling or any other activity included in the itinerary, or for any other mishaps to

yourself or your property, and in particular as a consequence of strikes, wars, riots, sickness or other such happenings. Any independent travel arrangements that you make are also at your own risk. While on the cycle, illegal behaviour or conduct considered unsuitable will not be tolerated and could result in the participant being asked to leave the cycle with no refund. The decision to participate in the cycle or parts therein lies with each individual. n Equipment Clients taking their own equipment on tour are responsible for any charges for transportation levied by the transport provider including excess baggage.

You must wear a helmet on this trip. Clients are responsible for ensuring that their bike is in a suitable condition for participation in a cycle of this nature.

The company will endeavour to accommodate clients, but cannot guarantee that correct tools and spares will be available. Clients will be expected to pay for any spares they require during the trip. n If you have a complaint Should you have a complaint about any of the tour arrangements, you must tell both the relevant supplier and the Company’s representative whilst on the trip or within 14 days of the end of the Event. It is only if the Company and the relevant supplier know about problems that there will be the opportunity to put things right. n Delays The timings of road, ferry or flight departures are estimates only. We cannot accept liability for any delay in your travel arrangements from or to Ireland whether the cancellation or delay is caused by adverse weather conditions, rescheduling by a transport provider, port authority, mechanical breakdown or industrial action. Where long delays result in lost challenge time, no refunds are given by hotels or suppliers. Similarly, transport providers do not offer compensation for delays. It is in recognition of the above that the Company’s travel insurance policy offers some monetary compensation for delays over 12 hours to cover lost time or delayed return.

This Event is conceived and operated by Irish Cycling Safaris Ltd. [Ground arrangements are fully insured through IrishCycling Safaris Ltd.] Irish Cycling Safaris Ltd, Belfield Bike Shop,UCD Belfield, D-4 WAIVER 16. Participants hereby acknowledge that they take part in the Event and all functions and events related thereto at their own risk. Participants hereby agree for themselves, their executors, administrators, heirs, next-of-kin, successors and assigns to waive release and discharge and to neither have nor institute any claims whatsoever against The Irish Hospice Foundation or Irish Cycling Safaris Limited.

This waiver covers death, disability, personal injury, damage to and loss of property of a participant and is effective whether or not such death, injury, damage or loss may have been caused directly or indirectly or wholly or partly by any act or omission including negligence, of The Irish Hospice Foundation or Irish Cycling Safaris Limited or their respective servants, agents and contractors and will bind the heirs, executors and/or trustees of the estate of a participant.

17. We are delighted that Paul Kimmage is supporting us. We cannot however guarantee his participation.

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IHF

The

Registration

E L C Y C C HA LLE NGE

SAT 18 - FRI 24 JUNE 2016 Are you a smoker?

PERSONAL DETAILS Title

FORM

________________________________________________

Yes

No

IHF Official Cycle Challenge 2016 Cycling Jersey.

Please see size chart and tick size req.

Name(s)

________________________________________________

Surname

________________________________________________

Address

________________________________________________ ________________________________________________

Cycle Jersey Size

S

M

L

XL

XXL

3XL

4XL

JERSEY SIZE CHART S HEIGHT cm 172 – 176 CHEST cm 92 -96

M L 175 – 179 178 -182 96 – 100 100 -104

XL 181 – 185 104 -108

XXL 3XL 184 – 188 187 -191 108 -112 112 – 116

4XL 190 – 193 116 -120

________________________________________________ Date of Birth (must be over 18) __________________________________ Sex (M/F)

________________________________________________

Phone (day)

________________________________________________

Phone (mob)

________________________________________________

Fax

________________________________________________

Email address

________________________________________________

NEXT OF KIN Title

________________________________________________

Name(s)

________________________________________________

Surname

________________________________________________

Address

________________________________________________

Will you be returning with the group on Friday 24th June?

Yes No If you are not returning with the group you must inform IHF before the 18th March 2016. If travelling separately from the group you are responsible for booking your own accommodation for the extra nights and your return flight home. We will be happy to provide you with the name and details of the hotel in Spain.

I have read and agree to abide by the Rules and Regulations in the accompanying event brochure which I understand may change from time to time and be posted on the web site www.hospicefoundation.ie. In particular, I have read and agree to the terms of the Waiver at clause 16.

Signed: ______________________________________ Date: _____________ PLEASE NOTE: All accommodation will be shared

________________________________________________

Do you have a preference for who you wish to share with?

Yes

No Please specify name__________________________________

If you do not wish to share there will be an additional single supplement charge, are you happy to pay this?

Yes

No

________________________________________________ Relationship

________________________________________________

Phone (day)

________________________________________________

Phone (mob)

________________________________________________

PASSPORT DETAILS

PAYMENT DETAILS I enclose a cheque for the amount of €250 made payable to the Irish Hospice Foundation Please charge €250 to my (Tick as appropriate) VISA MASTERCARD LASER

NB: Passport must be valid for 6 months after date of travel

Credit Card Number

Name (as on passport) _________________________________________

________________________________________________________________

Passport Number

_________________________________________

Exp Date CVV No ________________________________________________________________

Expiry Date

_________________________________________

Place of Issue

_________________________________________

Date of Issue

_________________________________________

Nationality

_________________________________________

Address Of Cardholder ________________________________________________________________

Country of Residence _________________________________________

________________________________________________________________

INSURANCE

During the fundraising time before the cycle your fellow cyclists may wish to contact you. If you agree to have your email shared with the other cyclists ONLY please tick the following box

Do You have travel insurance*

Yes

Name on Card ________________________________________________________________

No

* Travel insurance is Mandatory. Clients are responsible for ensuring that they are in possession of private Travel Insurance with protection for the full duration of the tour in respect of at least medical expenses, injury, death, repatriation, cancellation and curtailment, with adequate cover.

Do you have any special dietary requirements?

Yes No If yes, please give details. Please note we can only cater for allergies not preferences ________________________________________________________________

All information on The Irish Hospice Foundation Cycle Challenge 2016 is correct at time of going to press.

Participation in the cycle is at the sole discretion of The Irish Hospice Foundation Please return your completed application form plus deposit to: Ruairi McGinley, Irish Hospice Foundation, 32 Nassau St, Dublin 2, Ireland Ruairi is contactable at 01 679 3188 or ruairi.mcginley@hospicefoundation.ie

www.hospicefoundation.ie @IrishHospice Irish Hospice Foundation CHY: 6830