What is the $il(/er ^tarligfit
Tlic
Silvcr.Starliglit Walk is an 8 mile, ladies only fiilly marshalled walk, starting and ending at Ewood Park, Blackburii. Tlie aim of the walk is to raise money for the East Lancashire Hospice, which prorades care and support fpr the people of Blackburn, Darwen, Hyndburn and the Ribble Valley. Tlie Hospice heeds to raise £2.4 miliioh each year to continue this-care and relies heavily on donations and fiindraising events such as this
This year the Hospice marks 25 years of providing care and'support andjTis^elvw the walk that litde bit different To mark this special silver anniversaiy, we’re bringing a touch of silver and sparkle to;the walk and asking everyone to wear a silver tiara; We want the walk to be as-sparkly as possible, so_please feel free to use your imagination; ;'; whether it’s a silver wig, spray-on glitter, we dont mind as long as it s silver and sparldy!
• By taking part in the Silver Starlight Walk,'we’U not only guaranteeyoun*night‘tcfremember|, but we can guarantee that the money you rais.e through sponsorship will’make a real ^erenqp^ to. the lives of our patients and their families.
How can I join in:
$ili/er ^tarlig^t W fllh ^ Q 0 9 Registration Form (oneper entrant flease) •
Personal Information Title_______ First Name___ Home Address___________
Email Please tick here if you are happy for us to keep you updated of Hospice news via email □
Age (i f under 16 years old)_______ ______ ____________________ ___________ You need to be W years of age or older to lake part in the Silver Starlight Walk.
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I f you are under 16 years ofage please ensure your parent or guardian signs the form e Oi~. How did you hear about the walk? _ _ _ ----------------------------------------------------------- ' ■
Shirts ljS/t>(7senV £)
Size: Child □ Small (8-10) □ Medium (12-14) □ Large (16) □ X-Large (18+) U vara: would you like the Hospice to provide your tiara (£3) or would like to provide you^wn?
1 ospice to provide a tiara CD (please add £3 onto your payment) 1 will pro' ide m) own -iditional Information
■'.ease advise of any special dietary requirements:---------------- ------------------ - lease advise of any medical conditions: ---------------------------------------------------------------
; you know of anyone 'vho may be willing to volunteer on the night, please ghe their contact lame_____________________
_________ Tel No -- ------------------------ What else do I heed to know?
M we askis that you try to raise as much
sponsorship.money as possible from friends; family and colleagues, as the success'of the Silver Starligfit WHk rests entirely on
thg.sm'ount sponsorship money raised.
;.'imail--------------------------------- ------------------- ------------------------ -— -'ayment Details
i wish to pay my £15 entry fee by: Cheque D (payable to East Lancashire Hospice) .
Card type; Mastercard □ \hsa □ Switch/Maestro_D_^— , c .r ilb ,,c ]n n a x ] [ i i3 in D n o = i Start date I I l/l I I Expiry' date lZl[Zi/LjD Issue number Security' number I I
! I I (Last 3 digits on signature strip) Name on card . i'li- Cardholder’s address ( if different from above) . Postcode Si ned______________________________________ —— Your details will be held in the East Lancashire Hospice database and / > Date conf sent / / ______ _____ ]-------------
By signing theform, I confirm that I have read and accept the conditions of entry to the Walk and the rules and conditions o f this event. Entry forms that are not signed will
^ ^ Q
third parties. I f you do not wish to be kept updated about
Hosp.ee news, plea e
t.ck her U Please return to: Silver Starlight Walk, East Lancashire Hospice, Park Lee Rd, B ac urn OFFICIALUSE ONLY: Date received
. ' re /n K>rnrdn Surname Postcode
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