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Calke Abbey Walk Booking Form

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Calke Abbey Walk Booking Form Calke Abbey Walk booking form 1 Your details (Please print clearly) Title First name Surname D.O.B. Address Postcode Tel no. Email 2 Data protection By providing your email and/or telephone We would like to keep you informed about number you are agreeing that we may use the work of Parkinson’s UK. If you would not them to contact you about our fundraising like to receive further information about our Enjoy a great day out on We need your help and other activities. Should you wish at any activities then please tick this box. We our Calke Abbey Walk, in point to discuss how we communicate with will not share your details with any other The Rotary Club of Castle you, please contact our Donor Services third party or organisation for marketing association with the Rotary Donington is working with team on 020 7932 1303. purposes other than that of Parkinson’s UK. Club of Castle Donington. Parkinson’s UK to organise this There are two exciting routes event and raise much needed funds for people with Parkinson’s. around this beautiful National Trust 3 Terms and conditions property to choose from: There is no minimum sponsorship I/we understand that I enter the walk at The determination of what constitutes this required to take part in the walk, my own risk and that no person(s) or is reserved solely by the walk organisers. • A 3-mile circular route through but we suggest that walkers aim organisation(s) will be held responsible for the grounds of Calke Abbey Park Signature on behalf Date to raise at least £50. any accident, injury or loss to myself, prior of all walkers join and Ticknall Village. to, during or after the event. I understand (parent or guardian to sign We’ll be there to cheer you on the the organisers reserve the right to delay, if participant is under 18) • A 10-mile route taking in the day and award you with a medal. postpone or cancel the walk in the event grounds of Calke Abbey Park and of adverse weather conditions or other linking the two largest reservoirs Please help us find a cure and events outside the organiser’s control. in the National Forest at Staunton improve life for everyone affected us Harold and Foremark. by Parkinson’s. 4 Registration fees Every hour, someone in the UK is Please specify no. of entries: T-shirts (suggested donation £5 each) told they have Parkinson’s. Because 3-mile route Please specify number of t-shirts needed: we’re here, no one has to face adult(s) at £5 each Small Parkinson’s alone. under 16(s) free of charge Medium We bring people with Parkinson’s, their carers and families together via our network of local groups, Large 10-mile route our website and free confidential helpline Extra large adult(s) at £10 each Specialist nurses, our supporters and staff provide information and training on every aspect under 16(s) at £5 each I enclose a total of £ of Parkinson’s. Please make cheques payable to Parkinson’s UK As the UK’s Parkinson’s support and research charity we’re leading the work to find a cure, 5 Card payment and we’re closer than ever. We also campaign Mastercard Visa Maestro Delta to change attitudes and demand better services. Card no. Our work is totally dependent on donations. Start date Expiry date Issue no. (Maestro only) Security code* Help us to find a cure and improve life for everyone affected by Parkinson’s. *(the last three digits on the signature strip are required to complete your transaction) Cardholder’s name Cardholder’s signature Parkinson’s UK 215 Vauxhall Bridge Road ......................................................................................................................................................................................................................................................................................... London SW1V 1EJ Calke Abbey Walk Free* confidential helpline0808 800 0303 10am Sunday 10 April 2011 6 Further details (Monday to Friday 9am–8pm, Join us on a 3-mile or a 10-mile walk in spectacular surroundings Why are you taking part? Saturday 10am–2pm). Interpreting available. organised in association with the Rotary Club of Castle Donington. Text Relay 08001 0808 800 0303 ......................................................................................................................................................................................................................................................................................... (for textphone users only) Where did you hear about this event? Call 0844 225 9832 Email [email protected] [email protected] ......................................................................................................................................................................................................................................................................................... Visit parkinsons.org.uk/eastmidlands Would you be willing to help us with publicity for the event? parkinsons.org.uk *calls are free from UK landlines and most mobile networks. 2010-P3-04 ......................................................................................................................................................................................................................................................................................... Please return your cheque/credit card details and completed form to: © Parkinson’s UK, November 2010. Parkinson’s UK is the operating name of the Parkinson’s Disease Society of the Supported by Jessica Storer, Regional Fundraiser, Parkinson’s UK, PO Box 7842, United Kingdom. A company registered in England and Wales (948776). Registered office: 215 Vauxhall Bridge Alfreton, DE55 9DG Road, London SW1V 1EJ. A charity registered in England and Wales (258197) and in Scotland (SC037554). .
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