Sponsorship Form

Fill in this form and send it to me if you would like to sponsor me on my Land's End to John O'Groats bike ride in September 2018. I am raising money to restore the bells of St Giles church Leigh on Mendip. You can also use this form to send me your Gift Aid details.

Your name:
Your email address:
Your phone number:
Sponsorship amount:
Gift aid:
Publish my name:
Address (we only need this for Gift Aid)

Filling in this form won't ask you to pay any money up front, I will just add you to my list of sponsors and I'll contact you for the payment after I have done the ride.

Check the Gift Aid box and include your address if you are a UK taxpayer, this will allow us to reclaim tax on your donation when you come to pay it.

Check the Publish my name checkbox to allow us to put your name on our list of sponsors.

When you submit this form you will be added to our email list but you can unsubscribe at any time by contacting Julian Back.