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GUILD WHEEL CHARITY BIKE RIDE Sunday 30th September 2012 INDIVIDUAL, TEAM OR FAMILY APPLICATION FORM Name

Email

Mobile No.

Age if under 18 years

An email address is crucial as we will confirm bookings to each individual registered and send out a riders pack

If you wish to help out the event please indicate below. Can you also fill in the above form even though you are not actually participating in the ride

A mobile number on which you can be contacted is essential for the day of the bike ride

Can you also indicate if you have and First aid certificates

Please tick the ride in which you wish to participate 21mile Guild Wheel

10 mile (Brockholes-Preston Sports Arena)

2.5 mile (Brockholes- Shaws Arms)

Please tick if you wish to aid the event but not participate Support Riders

Marshalls/collection helpers

First Aid Certificate

Craig Easton, Recycling Lives Centre, Essex Street, Preston, Lancs, PR1 1QE. Email cseaston69@googlemail.com Tel: 07581342719


Application Form