Will be taking part in the 4



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_____________________________ will be taking part in the 4rd Stephen’s Story Ride Out, to raise funds for The Teenage Cancer Trust. In January 2013, item 1 on Stephen’s ‘Bucket List’ was his aim is to raise £10,000 for Teenage Cancer Trust. Once that figure had been achieved he then, selflessly raised the target and asked that this event be carried on as part of his legacy. Every day in the UK, six young people will be diagnosed with cancer. Your donations will go towards supporting them and improving their quality of life. This is not a commercial venture, all overheads are covered by the organisers and certain sponsors and all time is given freely. Every penny raised through this event goes straight to The Teenage Cancer Trust, in Stephen’s name. In 2013, the 1st ride-out raised over £5,500, in 2014 we raised over £8,500 and in 2015 we raised £10,500

Please sponsor generously – your support really matters. Any cheques should be made payable to ‘Stephen’s Story’ and will be presented directly to Stephen’s mom, Jane, through the Ride-out organisers on May 15th . By completing your FULL HOME ADDRESS with POSTCODE and ticking the Gift Aid box you will allow the charity to claim an extra 25 pence from the Inland Revenue (see below). Please hand in sponsor forms and totals upon arrival at Lichfield Rugby Club or take to Millenniumgroup, Lichfield (see supporters’ page on the website). If extra forms are required to span beyond May 15th please contact the event organisers, Colin & Elle Jacques via the contact page of the website, above with details of your extra fundraising.

The official bit . . .

If I have ticked the box headed ‘Gift Aid’ I confirm that I am a UK taxpayer and I would like Teenage Cancer Trust to treat all donations I have made for the four years prior to this year and all donations I make in the future as Gift Aid donations until I notify you otherwise. I confirm that I have paid or will pay an Income Tax and/or Capital Gains Tax for each tax year (6 April one year to 5 April the next) that is at least equal to the amount of tax that all charities and Community Amateur Sports Clubs that I donate to will reclaim on my gifts for that tax year. I understand that other taxes such as VAT and Council Tax do not qualify. I understand the charity will reclaim 25p of tax on every £1 that I have given (28p on every pound given for donations up to 5 April 2008).




Sponsor’s Name

Home Address

Postcode

Amount

Total

Collected


Gift Aid


(please tick)


Joe Sample

123 Homeway Rd

Islington, London



N5 1HP

£20

£20

































































































































































Sponsor’s Name

Home Address

Postcode

Amount

Total

Collected


Gift Aid


(please tick)


Joe Sample

123 Homeway Rd

Islington, London



N5 1HP

£20

£20

















































































































































































































































































The Teenage Trust (Trading) Limited - company reg no. 2691170 (England and Wales). In support of Teenage Cancer Trust - company
reg no. 3350311 (England and Wales), charity reg no. 1062559 (England & Wales); SC039757 (Scotland). VAT reg. no. 815 0652 50





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