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THE ROTARY CLUB OF SEVENOAKS AMHERST PRESENTS

THE CIRCUIT OF KENT CYCLO SPORTIVE 2012

Rider's Name

All sponsorship money donated will be given to Hospice in the Weald and Macmillan Cancer Support.

GIFT AID DECLARATION: We who have given our names and postcode below and who have ticked the box entitled "Gift Aid" want the Rotary Club of Sevenoaks Amherst on behalf of Macmillan Cancer Support and Hospice in the Weald to reclaim tax on the donation detailed below, given on the date shown. We understand that each of us must pay income tax or capital gains tax equal to the tax reclaimed by the charities on the donation (currently 28p for every £1 that we give).

Please make cheques payable to Sevenoaks Amherst Cancer Care, if possible on the day, but failing this completed forms should be returned to Derek Williams, Sevenoaks Amherst Rotary Club, 6 Hillydeal Road, Otford, Kent TN14 5RU.

PLEASE WRITE CLEARLY. THIS FORM MAY BE COPIED FOR FURTHER SPONSORS.

Sponsor's FULL name	House name or number & postcode	Amount pledged	Amount given	Date given	Gift Aid?