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Walker Registration Form

START/FINISH:
Car Park to Upton Court Park, Upton Court Road, Slough, SL3 7LU

The walks starts from 3rd Upton Scout Hut, any time between 9.00am and 1.00pm.
Finish any time up to 4.00pm.

Entry is £5.00 per adult in advance or £10.00 on the day
with accompanied children under 14 free.

Donations to Rotary Charites include
    • ShelterBox, Polio Plus, Youth Speaks
    • SHOC - Slough Homeless Our Concern
    • Thames Valley Hospice


If you are walking for a Charity,
Please select your charity from this dropdown list.
If your charity is not on the list and you wish to qualify for the
Rotary Incentives, please Sign-up your charity here.

 
WALKERS Names      
  First Name  Last Name  Under 14?
  1  No Yes
2 No Yes
2 No Yes
4 No Yes
5 No Yes
6 No Yes
7 No Yes
8 No Yes
9 No Yes
10 No Yes
  If you wish to register more than 10 walkers, please proceed with the first 10 through to payment and
then start again with a second form for additional walkers.

CONTACT PERSON   (credit card holder)
Please fill in all the boxes marked * 
Title*   
First Name*   
Last Name* 
House name/no* 
Street 
Town*    
County 
Post Code* 
Telephone* 
Email Address* 
I certify I am a UK tax payer and
wish to Gift Aid this Payment 
Yes No
To qualify for Gift Aid, you certify that you pay an amount of Income Tax and/or Capital Gains Tax at least equal to the tax that the charity reclaims on your donations in the appropriate tax year (25p for each £1 you give).
* Liability: I have read, understand and agree to the liability clause below. Please Tick
 Please check data entered carefully before continuing to payments, you will not be able to change it later.



All fields marked * are required for secure payment

Liability: Walking on public roads/footpaths can be hazardous and appropriate personal safety precautions should be taken. All walkers taking part in Slough Together Walk do so at their own risk. The Rotary Club of Slough, its officers and members, shall not be liable for any injury, damage or loss howsoever caused.