Everest Base Camp Trekin aid of Saint Michael‟s

Join Saint Michael’s on this fundraising trek to Everest

Base Camp. Follow in the footsteps of great

mountaineers into the wilds of the Nepali Himalayas.

A special challenge for you can make an extraordinary difference to others.

CHALLENGE YOURSELF ON A 12 DAY TREK 5 – 20 OCTOBER 2013

Registration pack

You‟ve taken the first step to doing something different. Challenging

yourself on this incredible 12 day expedition passing Kala Pattar at 5,545m and following in the footsteps of great mountaineers into the wilds of the Nepali Himalayas.

Give families the end of life care they want, need and deserve. Saint Michael‟s exists to provide specialist care and support for local people living with terminal illness and bereavement. Our services include inpatient care, day therapy, specialised care at home and bereavement support for people across the Harrogate District.

You‟ll be part of a team of trekkers most of whom will have never

done anything like this before. You're bound to feel daunted by the challenge – fundraising and training – but it‟s definitely achievable and you‟ll find the sense of achievement second to none.

Support along the way is always at hand. We‟ll give you plenty of

ideas to help you raise the funds and get yourself in good shape. If you have any questions at all give us a call – it‟s what we‟re here for!

To book your place simply send us:

• Registration form• Medical form• Fundraising agreement and• Cheque for £300Then the journey begins!

We‟ll look forward to hearing from you,

Rob Shuker, Challenge Fundraiser

(01423) 879687rshuker@saintmichaelshospice.orgwww.saintmichaelshospice.org

12 days of great trekking

The first day – Saturday 5th October: London/KathmanduDepart for Kathmandu on an overnight flight.

Day 2: KathmanduArrive in Kathmandu and transfer to a central hotel. Welcome dinner and briefing.

Day 3: Kathmandu - Lukla - Phakdiing (2656m)Fly to Lukla landing on a steep mountain runway which sets the scene for the forthcoming trek. Head up the Dudh Koshi Valley on a well-marked trail and then stay overnight in a lodge in Phakdiing.

Day 4: Phakdiing - Namche [3450m]From Phakding, we cross and re-cross the river on a series of high suspension bridges. Beyond Monjo is the entrance to the Sagarmatha National Park, set-up in order to protect and preserve the fragile mountain environment. We then take a steep hike to Namche where, if the weather is clear, we catch our first glimpse of Mt Everest. Overnight at a lodge.

Day 5: Namche (acclimatisation day)A day of rest to acclimatise to the altitude before continuing to trek higher. Perhaps visit Khunde Hospital, set-up by Sir Edmund Hillary, or take a gentle one hour walk up to the Everest View Hotel above Namche for the sunset view of Ama Dablam, Nuptse, Lhotse and Everest. Overnight at a lodge.

Day 6: Namche - Tengboche [3867m]From Namche, the trail contours on to the side of the valley, high above the Dudh Kosi where we get our first really good views of the great peaks of the Khumbu. Passing by several villages and numerous tea shops, we then descend steeply to a bridge over the river at Phunki Tenga. The village is an ideal stopover for lunch and a rest before making the steep climb to Tengboche. Although the hike up the zigzag path is tiring, you‟ll enjoy the beautiful sight of rhododendron bushes with beautiful birds and superb mountain scenery. Tengboche is famous for its legendary monastery, the largest in the Khumbu. Overnight at a lodge.

Day 7: Tengboche - Pheriche [4252m]We descend downhill through a forest, cross the Imja Khola and climb steadily to the village of Pangboche. This village is directly opposite Ama Dablam [6,856 m], and has exceptional views of the mountain, with the gompa, mani walls and scattered pine trees in the foreground. A further two hours walk brings us to Pheriche. Overnight at a lodge.

Day 8: Pheriche (acclimatisation day) Another day for rest and acclimatization. Perhaps wander up the valley to look at the Tshola Tsho Lake and the perpendicular walls of Cholatse and Tawache. You could also climb up onto the ridge overlooking Dingboche for a view of the Imja Valley and the incredible south face of Mt.Lhotse. Overnight at a lodge.

Day 9: Pheriche - Lobuche [4930m]We continue up the wide valley beneath the impressive peaks of Cholatse and Tawache on the left, and then turn right and take a steep climb towards the foot of the Khumbu Glacier. The tea house at Duglha is a good spot to have lunch. The trail then zigzags up through the boulders of the glacier's terminal moraine. The path then climbs gently along the glacier, to eventually reach the cluster of houses at Lobuche. Overnight at a lodge.

Day 10: Lobuche - Gorak Shep [5184m]To reach our next stop, Kala Pattar, we follow the Khumbu Glacier. The trail offers superb views of the surrounding mountains, especially where the path is forced to rise to cross a tributary glacier. We make our way to the top of one of the finest viewpoints in the Everest region, Kala Pattar [5554m]. As the light begins to fade we stroll back to our base at Gorak Shep and have an early night in preparation for our trek to Everest Base Camp the following day. Overnight at a lodge.

Day 11: Trek to Everest Base Camp [5357m]A very early start is required to reach the Everest Base Camp. It takes several hours as the trail weaves its way through ice pinnacles and past the crevasses of the Khumbu Glacier. On the return leg, we can take a higher route to get a spectacular view of the Khumbu ice-fall and the route to the South Col. We return to either Gorak Shep or Lobuche, depending on timings. Overnight at a lodge.

Day 12: Trek to Pangboche [3985m]Today's trek is mostly downhill. As we retrace our steps to Duglha and descend to Pheriche, we arrive at The Himalayan Rescue Association, a trekker‟s aid post and worth a visit. After lunch we cross the KhumbuKhola on a wooden suspension bridge and follow the Imja Khola to the village of Pangboche. Overnight at a lodge.

Day 13: Pangboche - Namche [3450m]We continue to follow the river and, after crossing it, climb back up through birch and rhododendron forest to Tengboche. Kwangde, Tawache, Everest, Nuptse, Lhotse, Ama Dablam, Kantega and Thamserku are just a few of the Himalayan giants to be seen. From Tengboche we descend to the bridge over the Dudh Kosi. At PhunkiTenga, see the water driven prayer wheels before making our way back to Namche. Overnight at a lodge.

Day 14: Namche - Lukla [2800m]Our final day's trekking follows the Dudh Kosi down to Lukla. Overnight at a lodge.

Day 15: Lukla - KathmanduPack up early and head for the airstrip for the flight back to Kathmandu. The rest of the day is at leisure. Overnight at a hotel.

Our final day – Sunday 20th October: Depart KathmanduTransfer to the airport for the flight home.

Please note: This itinerary is complex and may be subject to change.

Mileages and climbs are all approximate.

All you need to know

Amount to raiseThere‟s a £300 registration fee to cover our admin costs (non-refundable) and then we‟d like you to raise at least £3,400 in sponsorship. This may seem a lot but we‟ll send you plenty of advice –ideas which have already worked for other people. There‟s lots of different ways of doing it – we‟ve enclosed a few in this pack and will send you lot‟s more once you‟ve joined us. You‟ll be amazed at what you can achieve once you get going – people always are!

How the funds raised will be spent Of the funds you raise no more than £1,680 will be used to cover your costs and the balance will go to Saint Michael‟s. Our services include inpatient care, day therapy, lymphoedema support, planned respite care, specialised care at home and bereavement support for people across the Harrogate District.

Beat the targetWe want you to have a great time AND raise substantial funds for Saint Michael‟s. We hope you‟ll exceed the minimum sponsorship as all of the funds over the £3,400 go to Saint Michael‟s. If you don't reach the minimum target then you can make up the shortfall yourself. If you do have difficulties PLEASE get in touch with us – we‟re here to help.

What‟s includedFlights from the UK (excluding airport taxes & fuel supplements), all transfers and transport in Nepal, accommodation in a 3 star hotel in Kathmandu, lodges on trek, all meals throughout, local guides and porters on trek, Tour Leader, Doctor and charity representative. You will need to allow money for personal expenses (such as drinks, souvenirs etc) airport taxes, any visas or vaccinations, insurance and tips.

You and your trekkingThis is a challenge not a holiday! You will certainly need to train especially if you are not a regular trekker but its a great way of improving your fitness. We‟ll give you advice when you register about how to work out a training programme. You‟ll need to get used to using all of your kit and have included hills in your training. Its good to have trained on consecutive days before we set off and be able walk at an average of no less that 3-4 miles per hour on undulating terrain.

The plan each dayWe‟ll get an early start to the day so you got plenty of time for the trek. We‟ll stop mid-morning and mid-afternoon for a drink and snack and have a good lunch break. Within reason there will be scope to go at your own pace. We‟ll re-group at the stops so if you do trek fast you‟ll just have to wait a bit longer at the breaks! Your main luggage will be transported to the overnight stops and you‟ll have access to a small day bag so will only need to carry a few essentials with you whilst trekking.

Sleeping and eatingYou‟ll be staying in basic tea houses and lodges during the trek and hotels in Kathmandu. Rooms will be shared and will be en-suite wherever possible. The food in Kathmandu is varied. During the trek the food will be cooked on kerosene stoves and will be simple. Most of the food will be carried from Kathmandu. Boiled drinking water will be provided 3 times per day.

How fit do I need to beThis challenge is graded „Extreme‟, due to the rough terrain, altitude, and basic facilities. Anyone who leads a fairly active and moderately healthy lifestyle should be able to complete the trek as long as long as they train regularly over a period of three months leading up to it, so as to build up stamina and insurance. Don‟t forget that the temperature and the altitudes will be very different from the UK and that you will be exercising constantly for a number of days.

Book your place To register on the challenge you need to complete the registration form, medical form and the Saint Michael‟s fundraiser agreement (a legal requirement for you to be able to raise funds for Saint Michael‟s) and return all three with a cheque made payable to Saint Michael‟s to: Everest Base Camp Trek, Saint Michael‟s Hospice. Crimple House, Harrogate, North Yorkshire, HG2 8QL. Your place will then be confirmed and you will be sent further information about the event, how the money you raise could be spent, fundraising ideas and training advice. You need to be 18 or over.

Still have questions – give us a call (01423) 879687

Fundraising

Exceed your expectations: raise over £3,400 by 13th October 2013 Feeling daunted by the fundraising challenge? Never fear – most people do and then exceed what they set out to achieve! Use our top tips to get yourself off to a flying start.

Draw up a plan• You know things are much easier to achieve if you have a plan of

how to get there so discipline yourself!• Use the plan overleaf or draw up your own.• Get stuck in straight away as the longer you have, the easier it will be.

If you leave it „till later you‟ll have to work harder!• Divide your fundraising into chunks and spread it out through the time

available. Do something each month and make it relevant to the time of year.

Gather sponsors• Set up an online fundraising page with JustGiving. It‟s quick and easy

to do, you can email or send the details to all your contacts and your funds will start building straight away.

• Carry details of what you are doing with you everywhere you go. Whilst family and close friends may sponsor you larger amounts, the majority of sponsors will give you several pounds but if you gather this from a large number of people it can really mount up.

• You will need to collect money in as you go. When you start your sponsorship form or online fundraising page try and set out an example by beginning with a generous sponsor – hopefully other people will follow suit!

• Don't be afraid to ask everyone you know and those you don't –friends, family, work colleagues, members of the sports team you play for, your hairdresser!

• Give additional sponsorship forms to family and close friends to collect on your behalf, and ask if you can put one on display at your local shop, pub, club and gym.

Use your work contacts• Your work can be a great source of fundraising. Start by asking your

employer if the company will sponsor you. Many companies will, and some are prepared to match your funding pound for pound.

• E-mail or write to all of the businesses you work with (ask permission first!), and follow up with a phone call. Many businesses are especially keen to support charities to put something back into the community and may offer sponsorship of surprisingly large amounts. £50 - £200 donations are quite common and can make a huge difference to your sponsorship total and some people raise all of their funds this way. Businesses nay be able to offset the cost of sponsorship against tax.

Organise events• Events can be relatively simple to organise and can raise significant

amounts of money at a low cost.• Pick something that you enjoy and which you think your friends and

family will be interested in as well – a quiz night, 70s and 80s disco, themed Scottish evening, second-hand clothes sale, car washing, car boot sales to name just a few. We have loads of ideas you can use.

• Make the most of your contacts – think about who you know. Do you know someone who can be the chef, auctioneer, DJ at an event?

• Get a good turnout. Ask all of your friends to being a friend and double your numbers.

• Include a simple raffle, tombola and auction at your event with donated prizes as this can raise as much as the event itself.

HOW TO RAISE AT LEAST £3,400

Sponsor Me £ Set up and online page and email to everyone you know 200Get sponsored to give something up for a month or two:chocolate, alcohol, shaving, driving to work 50Friends and family 100Put your sponsor form up in 4 places: 4 x £25 100Work colleagues 50Businesses you work with and for: 4 x £50 200Ask everyone you know!: £1 in the pot 50

£750

Sell everything and anything £Sell tickets for a sweepstake eg premier football 50Shopping evening for the girls: jewellery, bags etc 150Sell unwanted clothes or presents or e-bay 100Hold an auction of priceless promises at your local pub 250Empty your garage and do a car boot sale 50Raffle a themed hamper eg Valentines 50Sell your services and organise a car wash 50

£650

A Big Bash £Theme your event: Burns Night Bash, Valentines SupperBook a venueOrganise food and barBook a band or a DJHold a raffleHave a mini auctionGet all your friends to bring a friend

£2,000You‟ve hit your target! £3,400

GO FOR IT – YOU‟LL HAVE FUN ALONG THE WAY!

How to register

How to registerTo register for the Everest Base Camp Trek 2013 please read the Conditions of Entry below, complete the Registration form, Medical form and Saint Michael‟s fundraiser agreement and post together with a cheque for £200 made payable to Saint Michael‟s to: Everest Base Camp Trek, Saint Michael‟s Hospice, Harrogate, North Yorkshire, HG2 8QL. Event details can also be found on our website: www.saintmichaelshospice.org

Conditions of entry1. To participate in Everest Base Camp Trek 2013 you must pay a non-

refundable registration fee of £300 to Saint Michael‟s for service provided

in relation to the organising of this event and commit to raising a minimum

sponsorship amount of £3,400 which must be sent to Saint Michael‟s by 4th

October 2012. Of this no more than £1,680 will be used to pay your trip

costs including accommodation, meals, and trek support. Saint Michael‟s

is a registered charity, nos. 518905 and 2121179, will receive 100% of the

net proceeds. Saint Michael‟s expects to raise £34,400 net from this

campaign, based on 20 participants reaching their minimum sponsorship

target, and after all costs have been met.

2. If you are unable to raise the minimum sponsorship amount you can make

up the shortfall yourself or forfeit your place and withdraw from the

challenge.

3. If you withdraw from the challenge you must inform Saint Michael‟s

immediately and ask all of your sponsors if they are still happy to make a

donation to Saint Michael‟s. If they decline you must ask them to put their

request for their funds to be returned in writing and forward this to Saint

Michael‟s for this to be arranged.

4. All sponsorship cheques must be made payable to Saint Michael‟s and

forwarded to Saint Michael‟s Challenge Events, Saint Michael‟s Hospice,

Crimple House, Harrogate, North Yorkshire, HG2 8QL. For paying in cash

you can either pay through our reception or you can make a BACS

transfer.

5. To reduce event costs correspondence will be by email and so you will be

required to provide an email address – either your own or one to which

you can have access.

6. You must be 18 years of age or over on the start day of the Event.

7. When fundraising and taking part in the challenge you must behave in a

manner which does not damage the reputation of Saint Michael‟s

Hospice; always act lawfully and follow the guidelines which are provided.

You will be acting as a Professional Fundraiser and you will be required to

sign a Professional Fundraising Agreement with Saint Michael‟s as

recommended by the Institute of Fundraising.

8. This is a very challenging event and in registering you must both confirm

that your general health is good and complete and sign a medical form

as well as commit to following the recommended training to prepare

yourself for the event. If you are unable to fulfil the challenge you will be

required to withdraw.

9. You must check with your doctor to ensure that you are medically fit to

participate in Everest Base Camp Trek 2013.

10. You acknowledge and agree that your personal information (including

medical information entered on your entry form or collected by event

staff) can be stored and used by Saint Michael‟s and the organisers in

connection with the organisation, promotion and administration of the

event.

11. You must be covered by your own travel insurance to take part in this

challenge. This must include insurance for trekking over 5,000m as well

third part liability and cover for your personal belongings.

12. You take part at your own risk, on the understanding that there may be

potential hazards during the event, and neither Saint Michael‟s nor the

organisers nor any related or affiliated organisation can take responsibility

for any loss or damage that occurs from your participation.

13. You must agree to abide by the instructors‟ directions and to se any

equipment provided responsibly and as instructed. You must indemnify

Saint Michael‟s and the organisers, and absolve them of all liability in

respect to death, personal injury, illness, loss or damage to person or

property to the fullest extent possible.

14. Saint Michael‟s and the organisers will accept no liability for the loss or

damage or for the cancellation of the event for any reasons outside their

control including false majeure.

15. You understand that, in the event of adverse weather conditions, major

incidents or threats on the day, the organisers reserve the right to

stop/cancel/postpone the Event.

16. Everest Base Camp 2013 will take place if a minimum of 20 participants

take part. If this is not achieved Saint Michael‟s reserves the right to cancel

or postpone the event. Should this occur your registration fee will be

returned.

17. The itinerary and accommodation arrangements for this event are

complex and subject to change.

18. You can confirm your name and video footage or photographs taken

during participation may be used on Saint Michael‟s publicity and

fundraising material to publicise this Event.

19. Saint Michael‟s reserve the right to withdraw places on the challenge if

they believe it is in the best interests of the event to do so.

Personal Details

Title Surname _____

Forenames Preferred Name _____

Address _____

_ Post Code _____

Email Home Tel _____

Work Tel Mobile _____

Twitter ID Facebook ID _____

Height m Weight kg _____

Date of Birth Occupation _____

T-shirt size )please circle) S / M / L / XL _____

Where did you hear about the event? _____

Please tell us why you have decided to join the challenge? _____

_______ _____

Next of Kin

Name Relationship _____

Address _____

_______________________________________ Post Code _____

Daytime Tel Evening Tel _____

Dietary Requirements

Please tick if you are a Vegetarian Vegan Other (please give details)_______

Accommodation

Rooms will be shared. Please give the name of anyone you would like to share a room with

_________________________________________________________________________________________

Registration form

DeclarationI would like to take part in Saint Michael‟s Everest Base Camp Trek 2013. I have read and agree to abide by the Conditions of Entry. I enclose my non-refundable registration fee of £300 and completed registration form. I commit to raising a minimum of £3,400 for Saint Michael‟s, which I understand must be received by Saint Michael‟s by 4h October 2013 for

me to take part. I confirm that my general health and fitness is good and take full responsibility for my own medical well being on the challenge. Saint Michael‟s, a registered charity, nos 518905 and 2121179, will receive 100% of the net proceeds. Saint Michael‟s expects to raise £34,400 net from this campaign, based on 20 participants reaching their minimum sponsorship target, and after all costs have been met.

Signature ____

Date

Registration form

Data protection and Privacy StatementSaint Michael‟s values your support and promises to respect your privacy. The personal information you provide is collected and managed in accordance with the Data Protection Act 1998 and will be used for the purpose of processing your registration to participate, and facilitating your participations, in Everest Base Camp Trek 2013 (the “Event”). In order to run the Event we will share your data with the organisers. We will not disclose or share personal information supplied by you with any other third party organisation without your consent.

Saint Michael‟s would like to keep you informed about other events you may be interested in. If you do not want to receive this information please let us know by ticking this box.

Your contact details including your name and email address will be shared with other Everest Base Camp Trek 2013 participants. If you do not wish to share your details please tick this box.

I am happy for Saint Michael‟s to contact me about other events that I may be interested in.

Please note: This is a very challenging event and you will need to have a good level of fitness – both aerobic fitness and strength in order to take part. You will be trekking long distances with substantial climbs on consecutive days.

Medical DetailsDoctor‟s name, address and tel no

_ _____

Are you taking and medication? If yes please give details

_ _____

Do you have any existing or long-term injuries? If yes please give details

_____

Do you have any existing medical conditions we should be aware of? (eg asthma, diabetes, high blood pressure). If yes please give details

_____

Do you have any allergies? If yes please give details

_____

Is there any other relevant medical information we should know about? If yes please give details

_____

If you have any pre-existing medical conditions please ask your Doctor to sign below to

confirm that you are fit and healthy enough to take part.

Doctors SignatureI confirm that (name) _____is, at the time of writing, well enough to take part in the Everest Base Camp Trek 2013

Doctors Name Doctors Signature _____

Medical form

Important If your medical details change at all between completing this form and the event you MUST inform Saint Michael‟s immediately and complete a new form.

I can confirm that I have declared any pre-existing medical conditions and that I am fit and health. I have understood that

this is a very challenging event and will undertake the necessary training required to complete the event and follow an

appropriate training programme as per receommended guidelines. I will inform my insurers of my medical conditions and

agree for my medical details to be passed on to the event organisers and for them to contact my GP should the need arise.

Signature Date

Saint Michael‟s fundraiser

agreement

Saint Michael‟s fundraiser agreement: Everest Base Camp Trek 2013Terms of your permission to collect money on behalf of Saint Michael‟s, registered charity number 518905.

As you will be collecting money from the public in support of Saint Michael‟s and you will be receiving a benefit by doing so, we are required by law to have written agreement with you in order to comply with the Charities Act (1992).

If you have any questions, please ring Rob Shuker on (01423) 879687. Thank you in advance for your support of Saint Michael‟s.

Terms of agreementBy participating in the Event to raise funds for Saint Michael‟s I agree with Saint Michael‟s that:

Registration and participation1. I will pay a non-refundable registration fee £300 to Saint Michael‟s.2. I will inform Saint Michael‟s Challenge Events Team immediately if I am unable to take

part in the Event. All monies paid to Saint Michael‟s to this point may be non-refundable and treated as a donation.

Minimum fundraising target3. I pledge to raise a minimum of £3,400 for Saint Michael‟s through my participation in the

Event.

Donations and payment terms4. I will keep details of the names and addresses of, and amounts donated or pledged

by, all donors and provide such details to Saint Michael‟s on request.5. I will regularly pay all money collected on behalf of Saint Michael‟s to Saint Michael‟s

directly within 30 days of me receiving the money.6. I will send an accompanying breakdown of how the money was raised and return all

used and un-used sponsor forms.7. I will pay Saint Michael‟s at least £3,400 of my fundraising by Friday 4th October 2013

with any remaining sponsorship to paid to Saint Michael‟s by Friday 15th November 2013.8. I will, if the sum of £3,400 has not been paid by Friday 4th October 2013, pay the

remainder from my own personal funds within one month of this date or in instalments to be agreed in writing with Saint Michael‟s.

Fundraising 9. I will comply with any fundraising guidance or advice issued by Saint Michael‟s.10. I will collect money on behalf of Saint Michael‟s in connection with the Event.11. I will use only lawful means to fundraise for Saint Michael‟s and will not do anything that

harms or is likely to harm Saint Michael‟s reputation.12. I will not use the Saint Michael‟s logo without permission and will obtain all fundraising

materials from Saint Michael‟s.

Note that we encourage you to set up an online fundraising page to collect sponsorship, but ask that you send any donation you may have received directly, or from fundraising events you may run, to us along with completed sponsorship forms where appropriate to enable us to reclaim the gift aid.

13. My fundraising will not include:a, Raising funds by carrying out door-t-door or unsolicited collections.b. Collecting in any public place without first obtaining a Saint Michael‟s collector‟s licence from Saint Michael‟s and authorisation from the local authority and any other licences or consent that Saint Michael‟s require me to obtain.c. Collecting on private property (including shops, pubs etc) without first obtaining a Saint Michael‟s collectors‟ licence from Saint Michael‟s and permission of the owner of the private property.d. Conducting any raffle or lottery or putting on any public Event without first contacting Saint Michael‟s and taking any steps which Saint Michael‟s require.

14. I agree that Gift Aid payments cannot count towards the fundraising pledge and instead will be considered as over and above the pledged fundraising total.

15. I agree that Saint Michael‟s can terminate my authority to fundraise on their behalf at any time by sending written notice to the address above.

Personal date and images16. I give permission for the free use of my name, picture, image, feedback and comments

in any future publicity, advertising, fundraising materials and/or promotion.17. I give permission for my personal information to be stored and used by Saint Michael‟s in

connection with the organisation, promotion and administration of the Event.

Health, safety and fitness18. I take part in the Event at my own risk and will not hold Saint Michael‟s or any connected

persons responsible for any accident, injury or illness sustained to the fullest extent possible in law.

19. I will fully prepare myself for the physical challenge of the Event and I will check with my

doctor to ensure that I am medically fit to participate in the Event.20. I will comply with any health and safety and other rules or guidelines issued by Saint

Michael‟s or any Event organisers.

Dates, changes and termination21. This agreement will be valid from the date on which I sign until Friday 15th November

2013, unless terminated earlier by Saint Michael's.22. Saint Michael‟s may vary or terminate this agreement by giving written notice to the

address above.

Declaration and signature23. By signing this form, I can confirm that I will be at least 18 on Friday 4th October 2013 and

I accept all the point stated in this Fundraiser Agreement.

Event Participant

Signed________________________

Print Name____________________

Date:_________________________

Accepted on behalf of Saint Michael‟s

Signed________________________

Print Name: Rob Shuker________

Position: Challenge Fundraiser__

Date:_________________________

Notes

Harrogate District Hospice Care is known locally as Saint Michael’s Reg. Charity No. 518905 Company Number 2121179

Saint Michael‟s exists to provide specialist care and support

for local people living with terminal illness bereavement. Our

services include inpatient care, day therapy, lymphoedema

support, planned respite care specialised care at home and

bereavement support for people across the Harrogate

district.

These services are provided free of charge to patients and

their families. We receive little government funding and rely

heavily on the generosity of the communities we serve who

fundraise tirelessly to ensure local families get the end of life

care they want, need and deserve.