WELLINGTON 2 WATERLOO BICYCLE RIDE

QUESTIONNAIRE / REGISTRATION

Your answers to these questions will be invaluable to us.

  1. Name: ______
  2. Address: ______

______

  1. Email:______
  2. Telephone: Landline: ______Mobile:______
  3. Sex:Male: ______Female:______
  4. Age:______
  5. I would like to take part in the W2W bicycle ride:Yes: ______No:______
  6. I have various family members and friends who would also be interested in taking part. The total number of these is:______
  7. My cycling experience is:
  8. I have limited bike experience:Yes: ______No:______
  9. I commute by bike:Yes: ______No:______
  10. I ride for weekend leisure:Yes: ______No:______
  11. Charity bike rides:Yes: ______No:______
  12. Some road racing:Yes: ______No:______
  13. Bicycles:
  14. I will require a bicycle:Yes: ______No:______
  15. My bicycle is suitable:Yes: ______No:______
  16. It is our aspiration to acquire sponsors for bicycles and cycling dress and equipment which will be suitably branded. Sponsors will be invited to either donate the required number of bicycle, dress and equipment or make them available at cost price to the rider.
  17. I would be interested in a new bicycle at cost price:Yes: ______No:______
  18. Cycling equipment:
  19. I have suitable equipment:Yes: ______No:______
  20. I will need suitable equipment:Yes: ______No:______
  21. I am interested in being part of the ‘support team’: Yes: ______No:______
  22. My car and I could be used as a support vehicle: Yes: ______No:______
  23. My van and I could be used as a support van: Yes: ______No:______
  24. I offer alternative support (e.g. Doc, Physio, Medic, Chef, Trainer, Bicycle Repair Mechanic etc.). Please describe: ______

______

______

  1. We are considering adding on a Battlefield Tour at Waterloo on Friday 27th September 2013. Your interest will help us make this decision.

I am interested in finding out more about the Battlefield Tour at Waterloo which will involve additional expenses on my part: Yes: ______No: ______

  1. I want to pay my deposit of £100 to guarantee my place: Yes: ______No:______

I enclose a cheque for £100

I would like to pay by credit card and will call you on 0207 414 3285

  1. I will not be able to take part in this epic event but would like to make a

donation to The Colonel’s Fund Grenadier Guards of £ ______

[ ]: I enclose a cheque payable to The Colonel’s Fund Grenadier Guards

[ ]: I have transferred the above amount directly to the Fund’s bank account

[ ]: I have donated the above amount to the Fund via

[ ]: I have donated the above amount via PayPal

[ ]: I have arranged a Standing Order / Direct Debit

[ ]: I have utilised a Payroll Giving Scheme

[ ]: I wish the charity to treat this donation as Gift Aid and to treat similarly all future donations that I make to the charity. I have paid or will pay sufficient UK income tax and / or capital gains tax in the relevant tax year at least to equal the tax that the charity is or will be able to claim on my donation(s) under Gift Aid. I will advise the charity should my circumstances change to affect the charity’s Gift Aid claims.

For corporate donations, please let us know what arrangements you have made in order that we can acknowledge them when funds are received.

Bank details:

Lloyds TSB Bank plc, Guards and Cavalry Branch, PO Box 1190, 7 Pall Mall, London, SW1Y 5NA

Account name:The Colonel’s Fund Grenadier Guards

Account number:01963343

Sort code:30 – 11 - 75

1