ENTRY FORM
for
6th HILLS & DALES WALK.
SATURDAY 6th September 2008
 please  complete and send to K G Bailey, 2 Lulworth Grove, Chell,
Stoke on Trent, Staffordshire ST6.6JY.
Telephone 01782 815386 .

Name...................................................................................................................................

Address.............................................................................................................. ..................
.......................................................................................... Post Code............................................
Telephone No.....................................e mail address.............................................................................
20 Mile Route Yes/No,
10 Mile route Yes/No,
7 Mile route Yes/No
Walker Yes/No
Runner Yes/No

WOULD YOU LIKE A SPONSORSHIP FORM............. Yes/No
Vegetarian meal Required....................... Yes/No
Amount enclosed £....................

All cheques payable to "Hills & Dales". All monies raised will go to  Chernobyl Children's Project (UK)

I agree to observe the country code and have read and accept the rules of the event. I also understand that I take part at my own risk and that the organisers accept no liability for injury, damage or any loss sustained by me. Where I am applying for more than my own entry I confirm that all other applicants applying with me accept the above conditions.

PLEASE ENCLOSE A SELF ADDRESSED ENVELOPE.

Signed............................ Date...............

GIFT AID FORM
Name.....................................................................................................................................
Address..................................................................................................................................
.......................................
Post Code............................
Please treat all subscriptions and donations I have made to the Chernobyl Children's Project (UK) as a Gift Aid Donation.
I understand that I must be a tax payer paying an amount of tax equal to the tax to be claimed.
Signature.............................Date...............
Amount paid............
Please remember to notify us if you wish to cancel this advise.
Any queries please e mail Russell and Ann Baker
Last updated on 3rd March 08