RideLondon - Surrey 100

31st July 2016

How to Apply

APPLYING FOR A GUARANTEED PLACE

  • Application for a guaranteed place is made through The Paget’s Association
  • All successful applicants will be required to pledge that they will raise a minimum of £500 sponsorship, paid in full to the Association by 30th November 2016
  • The Paget’s Association does not include Gift Aid in your sponsorship total. We do, however, ask you to encourage your supporters to tick the Gift Aid box on the sponsor form as this allows the Paget’s Association to claim an extra 25%
  • Before signing the application form, please read our terms and conditions carefully
  • Please give as much information as possible on your application form. You can attach

additional sheets if required

  • The closing date for applications is 1st April 2016
  • All applicants will be notified as soon as possible after this date as to whether or not they

have been successful in gaining a guaranteed place

RideLondon - Surrey 100

31st July 2016

Application Form

(Page 1 of 3)

Please send your completed form by e-mail to and post original signed form to:

The Paget’s Association

Suite 5, Moorfield House

Moorside Road

Swinton

Manchester

M27 0EW

Personal DetailsPlease complete this form using BLOCK CAPITALS

Title: / First Name:
Surname: / Date of Birth:
Address:
Post Code: / Daytime Tel. No:
Mobile No: / Evening Tel. No:
Home E-mail Address:
I am happy for The Paget’s Association to contact me by email
Occupation
Company
Do you have Paget’s disease?
Are you a member of The Paget’s Association?

Full Zip Cycle Top (please tick size required)

(32-34”) / (42”)
(34-36”) / (44”)
(38-40”)

RideLondon - Surrey 100

31st July 2016

Application Form

(Page 2 of 3)

Cycling for The Paget’s Association

Virgin London Marathon

RideLondon - Surrey 100

31st July 2016

Application Form

(page 3 of 3)

Important – please complete this section

I am pledging to raise:

£

*£500 Minimum required to be considered for a guaranteed RideLondon - Surrey 100 place

Terms and Conditions

  1. You must be at least 18 years of age by the date of the 2016 RideLondon - Surrey 100 event
  2. You must complete the pledge section above
  3. By signing your application form you are pledging to raise a minimum of £500 by 30th November 2016
  4. Entries close on1stApril 2016. Entrants will be notified of the outcome of their application as soon as possible after this date
  5. Successful applicants will be required to pay an entry fee of £25.00 to secure their place. (details will be provided when the places are allocated)
  6. You must inform The Paget’s Association,as soon as possible,of any injuries, or any other reason you would be unable to take part
  7. The organisers are keen to ensure rider safety and that as many people complete the RideLondon – Surrey 100 challenge within the time limit of nine hours.

I have read and understand the terms and conditions, and would like to be considered for a place, to cycle for the Paget’s Association. I confirm that to the best of my knowledge, my general state of health and fitness is good, and I expect to be able to complete the course within 9 hours. I take full responsibility for myself in taking part.

Signature: / Date:
Data Protection
The Paget’s Association takes data protection seriously. We assure you that we will not pass your details on to any other organisation. If you do not wish to receive further mailings from the Paget’s Association about our work, please tick the box.