Registration Form
Oakhaven Hospice
Please fill in all your details below and overleaf.
As your safety is of the utmost importance to us please read the
conditions of entry before you sign this form.
GIANT WATERSLIDE
I understand if I am in doubt about my health or have medical or respiratory
conditions that could be affected by exercise, I should obtain my doctor’s
approval before participating. Please also download the full safety instructions
and FAQ’s from our website.
Lymington High Street
as it’s never been seen before!
I acknowledge that I participate in this event at my own risk and Oakhaven
Hospice cannot be held liable for any injury, loss or damage caused or
sustained as a result of my participation. I confirm that I will abide by all the
rules and regulations set out by Oakhaven Hospice for participating safely in
this event and obey the on course instructions of the run marshalls.
I understand this is a fundraising event and pledge to raise as much sponsorship
as possible and that the entry fee is non-refundable as it covers the cost of
administering the event. In case of adverse weather conditions please check
our website www.oakhavenhospice.co.uk or follow us on Facebook / Twitter
Signed:
Sunday
10th July 2016
Whilst sponsorship is not complusory, just
imagine the difference it could make ...
Date:
£25.22 = Complimentary Therapy treatment
Total payment£
£30.15 = Physiotherapy treatment
Cheque made payable to: Oakhaven Hospice Trust
£403.68 = 24 hours care in our InPatient Unit
Please hand this form into the Hospice or send to the address overleaf.
Payment by Credit/Debit
Card I authorise you to debit my card with the
Thank you for your support
total on this form.
Card No
Security No*
Expiry Date
Signature
*the last 3 digits located on reverse of card
OAKHAVEN making every moment matter
kindly sponsored by
Don’t miss this one off, never seen
before opportunity to ride the slide
down Lymington High Street!
Ride the slide from 10am onwards – you will be given a
preallocated time with your entry pack.
You will travel all the way from Costa Coffee
Secure Bag Drop, so participants can bring a change
of clothes.
down to the buffer zone that ends on Gosport Street
on our giant inflatable waterslide.
Registration will be at Community Centre. You need to be at the entrance to the slide 15 minutes before your allocated time slot, so please leave plenty of time.
Further instructions will come with your entry pack.
We have had an overwhelming response so
please return your form as early as possible
to avoid any disappointment.
(PRE-BOOKED ONLY - NO TICKETS ON THE DAY)
Adult £15
Child
£10
7 and over only
Name:
Address:
Postcode:
Telephone:
Email:
We would like to keep you informed about Oakhaven events. If you do not wish
us to contact you either by post or email please tick this box
You will be wet at the end of the slide so come prepared!
Fun outfits and fancy dress are fully encouraged.
Simply fill in the attached entry form and return it to us for
your entry pack & slide time.
To ride the slide please complete clearly on both sides ...
Name
Adult
Child Family
£
If you like our WATERSLIDE you’ll LOVE these
events. For up to date event information check out
our website or follow us on
THE New Forest Bike Event
Oakhaven Hospice
BIKE & HIKE
Hollands Wood Campsite, Brockenhurst
incorporating
Woofs & Wellies
Saturday 1st October
2016
For details call 01590 613038
or check www.oakhavenhospice.co.uk
For the 1st time
Family £40
IT’S ON SATURDAY!
Oakhaven Hospice
Santa DaSH
Sunday 4th
December
Registration 10am
EntRY
InCLUDES
YOUR
Santa
SUIt!
www.oakhavenhospice.co.uk /
fundraising events
(2 x Adults/2 x Children)
registered charity no 200915
Registered charity no 900215
A fundraising design
registered charity no 900215
Optional donation *
* Boost your donation by 25p of Gift Aid for every £1 you donate. Gift Aid is reclaimed by the charity from the tax
you pay for the current tax year. Your address is needed to identify you as a current UK taxpayer. In order to Gift Aid
this donation you must tick the box: I want to Gift Aid my donation of £………………… to Oakhaven Hospice.
I am a UK taxpayer and understand that if I pay less income tax in the current year than the amount of Gift Aid
claimed on my donations it is my responsibility to pay any difference.
TOTAL
I/we understand that Oakhaven Hospice may take photographs of me/us taking part in this
event and permit them to use images for promotional purposes. If signed on behalf of a child, I
give permission to use their image.
Signed:
Please send this form (completed on both sides), together with
your registration fee to:
Fundraising, Oakhaven Hospice, Lower Pennington Lane,
Lymington, Hampshire SO41 8ZZ