The Trinity500 Lighthouse Abseil Challenge

I would like to register to participate in the abseiling event: Southwold Lighthouse, Suffolk, on Saturday 5 July Nash Point Lighthouse, Glamorgan, on Friday 11 July Portland Bill Lighthouse, Dorset, on Saturday 19 July

Please choose:

Southwold Lighthouse Nash Point Lighthouse Portland Bill Lighthouse

Name

Address

Postcode

Mobile

Date of Birth *

* For insurance purposes participants must be aged 18 years or over

Please note: The number of participants is strictly limited to 50 people per lighthouse location. The first 50 people who apply for each location, who meet the criteria and enclose their entry fee of £30, will be allocated the place.

I would prefer to do my abseil in the: Morning (from 10.00-13.00) Afternoon (from 13.00-16.00) We will do our best to accommodate your time request Entry Fee Entry is £30 per person and is non-refundable. Without payment being included with the entry fee your entry form will not be processed.

METHOD OF PAYMENT Visa Credit Visa Debit Mastercard Cheque Card Number

Start Date Exp’y Date Security Code (located on the back of the card) Card Holder’s Signature

Please email your completed form to Name on card [email protected] or, in the case of Billing Address payment by cheque, post it to: Phillip Cruddace, Trinity House, The Quay, Harwich, CO12 3JW Please make cheques payable to the Corporation of Trinity House Post Code Please note that we do not accept American Express cards Tel. No.

We will notify you of your acceptance (or otherwise) on the abseil, and your allotted abseil time in the next couple of weeks. If the event is fully subscribed your payment will not be taken and you will be notified of this.

Fundraising It is now even easier to donate to The Corporation of Trinity House, which annually donates c.£4m to maritime charities, through Just Giving at https://www.justgiving.com/corporationoftrinityhouse If your sponsors are UK taxpayers their donations can be worth 25% more at no extra cost to themselves.

Rules of Participation By completing and submitting this form you are agreeing to the terms of participation which are: • We retain the right to refuse any individual(s) access to the abseiling event if we believe the rules of participation have been breached or if the safety of either the participant, event team or audience would be jeopardised by allowing the individual’s abseil (or the entire event) to continue. • Participants must be aged 18 years or over on the date of the abseil. • We regret we are unable to refund entry fees once payment has been made.