Taff Trail Bike Ride
Saturday 12 September 2015
Taff
Trail
TaffTrail
Trail
Taff
Bike
Ride
Bike
Ride
Bike Ride
Miles
from
Brecon
50 50
Miles
from
Brecon
50 Miles from Brecon
50
Miles
from
Brecon
or
25
miles
from
Merthyr
50
Miles
from
Brecon
to
Sophia
Gardens
to
Sophia
Gardens
to
Sophia
Gardens
to Sophia
SophiaGardens
Gardens
to
Saturday 12 Sep 2015
Limited transport available - Cardiff to Brecon
Cycle
withwith
us from
from
the heart
heart
of the
the
Brecon
Beacons,
Cycle
us from
the heart
ofBrecon
the Brecon
Beacons,
Cycle
with
us
the
of
Beacons,
Cycle
with
usheritage
from
thelandscapes
heart of
Brecon
Beacons,
through
heritage
landscapes
onthe
virtually
traffic-free
through
on
virtually
traffic-free
through
heritage
landscapes
on
virtually
traffic-free
through
on virtually traffic-free
routes
allheritage
the
way
to Cardiff.
Cardiff.
routes
all way
thelandscapes
way
to Cardiff.
routes
all
the
to
routes all the way to Cardiff.
www.stdavidshospicecare.org 01633 851051
Supported by:
Find us on: us on:
Find usFind
on:
Find us on:
Supported
by:
Supported
by:
Supported
by:
Supported by:
Registered charity
Registered charity
Registered
charity
number: 1010576
number: 1010576
number:
1010576
Registered
charity
number: 1010576
Taff Trail Bike Ride 12 Sep 2015 – Registration Form
Taff Trail Bike Ride 2012 Registration Form
ail Bike
Taff
Ride
Taff
Trail2012
Trail
BikeBike
Registration
Ride
Ride
2012
2012
Registration
Form
Registration
Form
Form
Meeting at Brecon High School, in the Market Town of Brecon. We will be cycling 50 or 25 miles through open
moorland of the Brecon Beacons and a wide variety of urban and suburban landscapes, passing close to
Merthyr
Pontypridd,
and then
finishing
Park/Sophia
Cardiff.open moorland of the
We will beTydfil,
cycling
50 miles, meeting
at the
theatreat
in Bute
the market
town of Gardens
Brecon, through
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not a Race!
hope that
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ng 50 miles,
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will
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the through
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theinof
icycle
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all
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sponsorship
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ourof
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and then
finishing
at the
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ns and a wide
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andand
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a wide variety
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the
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d then finishing
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at
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and
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finishing
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thestart
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at the
Sophia
Gardens
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into
Cardiff.
in Cardiff.
>
The
ride
will
have
rolling
from
8.30am
>
-shirts
are of
available
for purchase
via Fundraising
>Pontypridd
The
ride
will
begin
ata10.00am
>T
On
receipt
this entry
form St David’s
Hospice Care will
9.30am
prompt.
>
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are encouraged
> T-shirts
are
available for purchase
forms to take part.
egin at 10.00am
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are encouraged
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part time of registration, >
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please
complete
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form below
and return
to:
ailable for>purchase
T-shirts
> T-shirts
are
available
are
available
for purchase
for150
purchase
issue to
sponsor
forms
issue sponsor
issuesponsor
sponsor
forms forms,
forms together with confirmation.
places
are
to
(Cardiff
Brecon
only).
issue
> The
route
willlimited
be marshalled
and refreshments
will
be
Taff Trail Bike Ride
2012, Fundraising Department,
ouraged to
> Teams
take part
> are
Teams
encouraged
are encouraged
toAvailable
take part
to take
>part
To
register
pleaseMerthyr.
complete
> To the
register
>form
register
please
belowcomplete
and
please
return
complete
the
to:form
the
below
form
and
below
return
and
to:
return
>
Transport
NOT
for
the
25ml route,
>
TTo
o register,
please
complete
the
form
below
and
returnto:
available along the way
St David’s Hospice Care, Blackett Avenue,
>
The
collection
forrefreshments
transport
for
Brecon
at
to:
Taff
Trail
Bike
Ride
2015,
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be marshalled
> Theand
route
> refreshments
The
will
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be marshalled
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willpoint
marshalled
be and
andTaff
refreshments
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beRide
willwill
be beFundraising
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Taff
Bike
Department,
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2012,
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Fundraising
2012,
Fundraising
Department,
Department,
> The
collection
pointCardiff
for transport
to Brecon
will be at
Newport, NP20
6NH Hospice Care, Blackett Avenue,
Sophia
Gardens,
at
7.30am
prompt
Department,
St David’s
g the way available
available
along the
along
waythe way
St David’s Hospice Care, Blackett
St David’s
St
Avenue,
David’s
HospiceHospice
Care,
Blackett
Care, Blackett
Avenue,Avenue,
Sophia
Gardens
at 8.30am prompt
> Newport,
The minimum
age foror
this event is 14, anyone under 16
(CF11
9LJ)
NP20
point for transport
> The collection
> The
to
Brecon
collection
point
will
for
be
point
transport
at for transport
to Brecon
to Brecon
will be
atwill6NH
be at
Newport,
NP20
Newport,
Newport,
NP20 6NH
NP20 6NH
6NH register online via our website.
> The bike
ride
isbe
formarshalled
both men and
women,
for all levels
of
must
be accompanied
by a parent
or guardian
>The
route
and
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he minimum
age event
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ns at 8.30am
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atwill
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under
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under 16
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16
fitness
and
can the
be taken
at your own pace, it is not a race!
>must
If an individual
is younger
than
16 years
of age a parent or
available
along
way.
be
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s for both men
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> Entry
is £10pp
an additional
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if transport
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start
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(non-refundable).
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> guardian
If you require
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on
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> Entry is
>£5
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£10pp
pp
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and
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an
additional
and
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an
the
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to
the
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must
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the
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disclaimer
below
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taken at your
own pace.
> Iplease
f you require
any
information
endeavour
to raise
as much sponsorship as possible to
contact
usfurther
on 01633
271364 on the event, please
d (non-refundable).
start is
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hope
required
(non-refundable).
that you
(non-refundable).
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> required
EWe
ntry
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£25pp
orWe
£15pp
contact
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on
01633
851051
support
workwith
in thetransport
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email [email protected]
raise as much
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01633 271364
transport
(Non
Refundable).
email:
or visit our website www.stdavidshospicecare.org
ork in the community
supportsupport
our work
our
in the
workcommunity
in the community
email [email protected]
email [email protected]
email
or
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our website www.stdavidshospicecare.org
or visit our website www.stdavidshospicecare.org
or visit our
or visit
website
our website
www.stdavidshospicecare.org
www.stdavidshospicecare.org
Sponsor online: www.justgiving.com/sdf/raisemoney
e: www.justgiving.com/sdf/raisemoney
SponsorSponsor
online: www.justgiving.com/sdf/raisemoney
online: www.justgiving.com/sdf/raisemoney
Where did you hear about this event?
u hear aboutWhere
this event?
did
Where
you did
hear
you
about
hearthis
about
event?
this event?
Participant Mr/Mrs/Miss/Ms
First Name
Surname
r/Mrs/Miss/Ms
Participant
Participant
First Mr/Mrs/Miss/Ms
Name Mr/Mrs/Miss/Ms
First Name
First Name Surname
Address
Surname
Surname
AddressAddress
Postcode
Postcode
Mobile
Telephone
Telephone
Telephone
Email
Mobile
Postcode
Postcode
Mobile Mobile
Email Please
Email
read and sign: I understand that this is a sponsored event and will endeavour to raise sponsorship to support the work of St David’s Hospice Care. I certify that I release
IStwould
like to take part in (please tick):
50 mile Bike Ride
Transport Required
25 mile Bike Ride from Merthyr
David’s Hospice Care, and their agents, officials and volunteers for any injury / loss caused through my participation in this event. I take part entirely at my own risk. I agree
that
seeksign:
medical
advice
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Participant
Participant
Participant
Signed:
Date:
n if child isParent/Guardian
under 16
Parent/Guardian
(minimum
if child
ageisif14)
under
child is16
under
(minimum
16 (minimum
age 14) age 14)
Signed:
Date: Date:
Date:
50
Miles
Donor
numberfrom Brecon
(Internal use only)
to
Sophia
Gardens
Donor number
Donor number
Signed:
St Signed:
David’s Hospice Care values your support and promises to respect your privacy. Date:
The data we gather and hold is managed in accordance with the Data Protection
ActDavid’s
(1998).
Ifto
you
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wish
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Taff Trail
Bike Ride
Date:
Signed:
Signed:
Parent/Guardian
if child is under 16 (minimum age 14)
Payment
Date: Child
Date:Age:
(Internal use
(Internal
only) use only)
I enclose a cheque (made payable to St David’s Hospice Care)
Please debit my debit/credit card
(made payable
to
I enclose
St
David’saHospice
cheque
(made payable
Care)
(made to
payable
St David’s
to StHospice
David’s
Care)
Care) Please
Please
debitHospice
my debit/credit
carddebit
Please
my
debit
debit/credit
my debit/credit
card card
I enclose
a cheque
I enclose
a cheque
Payment
Payment
Amount
£10 pp/
£15 pp
(if transport
required)
with
£10
Amount
pp/ £15
Amount
(if transport
£10
required)
pp/£25pp
£10
£15pp/
pp
(if
£15
transport
pp (if transport
required)
required)
Cardpp
type
VISA
MASTERCARD
Card
VISA Card type
VISA VISA
Card type
No. MASTERCARD
Card No.
Card
No.
Valid from
Valid from
Valid
Issuefrom
No. (If applicable) Expiry
MASTERCARD
MASTERCARD
DELTA
£15pp
without transport MAESTRO
DELTA
MAESTRO
DELTA DELTA
Expiry
Security Expiry
No. (Last 3Expiry
digits on back of card)
MAESTRO
MAESTRO
Cycle with us from the heart of the Brecon Beacons,
through heritage landscapes on virtually traffic-free
routes all the way to Cardiff.
Issue
(If
Security
applicable)
No. (IfNo.
applicable)
(Last 3 digits on back ofSecurity
card)
Security
No. (Last 3No.
digits on
(Last
back
3 digits
of card)
on back of card)
Issue No.
Alternatively, to make a payment over the telephone, please call 01633 271364
Alternatively, to make a payment over the telephone,
In partnership
with:
Supported
by:
Find us on:
ely, to make
Alternatively,
Alternatively,
a payment
to make
over
to
make
the
a payment
telephone,
a payment
overplease
over
the telephone,
the
calltelephone,
01633
please
271364
please
call
01633
call
01633
271364
271364
please
call 01633
851051
Registered charity
number: 1010576