*With a minimum of £30 sponsorship

Entry Fee*

£20

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SEA SWIM18 September 2011

One Mile Sea Swim

Broadsands, Paignton

Supported byTorbay Council

Sponsored by

TERMS AND CONDITIONS OF ENTRY

This event is organised by the Devon Air Ambulance Trust, whose registered office is at 5 Sandpiper Court, Harrington Lane, Exeter,EX4 8NS, working in partnership with BBC Radio Devon.

Thereby the parties above shall be known as ‘the organiser’.

By entering the swim you agree to abide by the Conditions of Entry and any race instructions given to you by the organisers andofficials of Agatha Christie Sea Swim.

Swim ProficiencyBy entering the Agatha Christie Sea Swim, I hereby declare that I will undertake adequate swim training to enable myself to complete aone mile swim unaided and that I am a competent swimmer.

Medical ConditionsIt is strongly recommended that you train for the swim and prepare for the challenge. If you have not exercised before or for sometime, consult your doctor for a check up.

Race EjectionThe event organiser reserves the right to refuse an entrant’s attendance at, and/or participation in, any of its events and/or a trainingswim if applicable. No dogs or other animals are allowed to swim in the event. We are continuing in our mission to organise theworld’s best, safest and most enjoyable swimming event and hope you will help us in achieving this. Any participant who is found inbreach of these terms and conditions will be excluded from future events. Please do not put someone else at risk.

Change of AddressIf your address details change after you have submitted your application, please email us with details of your old and new addressesand date of birth at info@daat.org

For Reasons of SafetyNo fancy dress will be permitted.

Data ProtectionThe organiser complies with the Data Protection Act 1998 and you have the right of access to your personal records held on ourcomputer. Your name will be added to our mailing list so that we can keep you informed about the charity and also other eventswhich you may be interested in. This information will not be passed on to any third party. You are entitled to withdraw your consentto this process by ticking the appropriate box on the sponsorship form.

Swim HatsFor safety reasons and primarily for the identification by medical staff, we strictly prohibit the swapping, sale, re­sale or transfer of theswim hats. Your issued swim hat must be visible at all times.

Swim MementosOnly finishers will receive a commemorative medal. Non­participants are NOT eligible for event mementos. The event organiserreserves the right to change the style, size and type of event mementos offered to finishers.

Collection and Use of InformationYou acknowledge and agree that your personal information (including medical information collected by event medical staff during orafter the event) can be stored, used and disclosed by the event organiser in connection with the organisation, staging, promotion andadministration of the event and for the compilation of statistical information.

Use of ImagesBy entering the race you give permission to the free use of your name, voice or picture to any broadcast, telecast, advertising,promotion or other medium at the Agatha Christie Sea Swim and BBC South West.

Water Temperature and WetsuitsIf the water temperature falls below 15oC on the day of the event, wetsuits will be compulsory and no swimmer will be allowed in thewater without a wetsuit. We recommend wearing a swim specific wetsuit, ie those suits designed for triathlons, which will provideextra buoyancy and warmth.

Age Limits All participants in the Agatha Christie Sea Swim must be 16 years of age or over on 18 September 2011. Entries for those aged 16­18on the day of the swim must have their entries countersigned by a parent/guardian.

Entry Fees£20 plus a minimum of £30 sponsorship for all UK residents. Applications will be accepted up to 12 September 2011. Entries will notbe accepted after the closing date.

Swim CancellationIf the event is unable to take place due to unforeseen circumstances, the organisers will be entitled to cancel the event. In suchcircumstances, we will try to let you know in writing of the cancellation. In the event of cancellation your entry fee and sponsorshipreceived via any online giving site is non refundable and the event organiser will accept no other liability to you for any costs orexpenses you may incur as a result of that cancellation. In the event of a delay in the event which is due to unforeseen circumstancesbeyond our reasonable control, we will have no liability to you for any costs or expenses you may incur, although you may opt tocancel your place and in that case your entry fee and sponsorship as mentioned above is non refundable. Announcements of anycancellation/postponement will be via email, on Devon Air Ambulance Trust website and BBC Radio Devon. Please ensure you enter avalid email address on your entry form.

PAYMENT DETAILS

I enclose a cheque for £20 per swimmer (tick box): Please make cheques payable to ‘BBC Radio Devon Air Ambulance Appeal’

I’d like to pay my entry of £20 by credit/debit card (tick box): (Please complete details below)

Visa Maestro Mastercard Issue No (If applicable)

Card number:

Start date: Expiry date:

By signing this form I confirm that I have read and accept the terms of entry as set out in this entry form.

Signed: Print name:

Date:

If you are between 16 and 18 years old, please ask your parent/guardian to countersign your form below:

Signed (by parent or guardian): Print name:

Date:

BBC RADIO DEVON AIR AMBULANCE APPEAL

This event is raising funds for the BBC Radio Devon Air Ambulance Appeal.

In January 2010 BBC Radio Devon announced they had chosenDevon Air Ambulance Trust as their charity partner.

The purpose of the Appeal is to raise £600,000 with the help ofBBC Radio Devon listeners. This sum will facilitate the ordering of asecond owned helicopter. The charity already owns one. Owningrather than leasing saves in the region of £12,000 a month ­ sowith two helicopters there are even greater savings!

Devon Air Ambulance Trust is the charity which raises the funds tokeep both of Devon’s Air Ambulances airborne. Independent ofGovernment and National Lottery funding, every penny of the £4.5 million needed comes from the goodwill and generosity of the community, businesses and friends of Devon.

If you would like to find out more about Devon Air Ambulance Trust, why not get in touch?

01392 466666 info@daat.org www.daat.orgDevon Air Ambulance Trust, 5 Sandpiper Court, Harrington Lane, Exeter, EX4 8NSRegistered Charity No: 1077998 Company No: 3855746

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Security code:(Last 3 digits on back of card)

Printing supported by

Entry FormYOUR PERSONAL DETAILS

Title (e.g. Mr, Mrs, Ms etc): First name:

Surname:

Address:

Postcode:

Telephone: Mobile:

Email:

Date of Birth:

Age on day of swim (please tick) 19 – 25 26 – 35 36 – 44 45 & over

16 – 18 (Age limit ­ entrants must be 16 or over on 18 September 2011. Entry forms for those aged 16­18 on the day must be countersigned by a parent/guardian by way of consent)

How did you hear about this event?:

EVENT SPECIFICS

How long do you consider it will take you to swim one mile? (Tick one box only)

40mins 50mins 60mins

80mins Over 80mins (maximum time limit 1hour 45mins)If you would like to swim with a friend or family member who is also entering the swim, please state their name(s)

Name: Name:

Please tick your preferred swim time am pmWe will endeavour to allocate you your preferred time, although this will be determined by your individualestimated time taken to swim one mile

Do you consider yourself to be a competent swimmer? Yes No

Medical conditions (Please state):

Current medication (Please state):

On the day emergency contact details:

Contact name: Relationship to you:

Home telephone: Mobile:

Gender: Male Female

Note for participants We never give your information to other organisations for marketing purposes. Your details will be used byDAAT. We would only give your data to another organisation if required to do so by law. We would like to send you news andinformation about DAAT and other ways to support us.

If you do not wish to receive this information, please tick this box

If you would like to set up an online sponsor page please log onto www.justgiving.co.uk and search ‘Devon Air Ambulance Trust’following the instructions on screen to set up your page/account.

Note for sponsors If the named participant does not take part, any sponsor monies handed over to DAAT will be deemed as adonation to the charity.

Please tick the Gift Aid box if you would like DAAT to claim tax on your sponsorship donation; this will addto the value of the amount you donate without it costing you any extra. For example, at a basic rate of20% DAAT would receive 25p extra for every pound you donate. To qualify for Gift Aid, what you pay inincome/capital gains tax must be at least equal to the amount we claim on your donation in the tax year.

It is a requirement for you to use your home address and postcode to enable us to make the claim. We never give yourinformation to other organisations. Your contact details will not be used by DAAT or passed to any other companies; details willonly be used to reclaim Gift Aid on your donation where applicable. We are unable to claim Gift Aid on any sponsorship where acompany address is provided.

Sea SwimSponsorship Form

Name(Please use capital letters)

Home address(Please use capital letters and provide your home address;

DAAT will not use your personal details to contact you in any way)

Postcode(Your postcode

must be suppliedin order for us toclaim Gift Aid foryour donation)

Gift Aid(√)

Amountpledged

Amount collected

MR A N OTHER 1 HIGH STREET, ANYTOWN, COUNTY AB1 2FD √ £10 £10

Sub total

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Title (e.g. Mr, Mrs, Ms etc):

First name: Surname:

Address:

Postcode:

Telephone: Email:

Sub total

Name(Please use capital letters)

Home address(Please use capital letters and provide your home address;

DAAT will not use your personal details to contact you in any way)

Postcode(Your postcode

must be suppliedin order for us toclaim Gift Aid foryour donation)

Gift Aid

(Tick)

Amountpledged

Amount collected

Sub total

Total

SPONSORSHIP FORM (continued)

• You must not consider Gift Aid as contributing towards your sponsorship target, but see it as anaddition to your target.

• Please return all sponsorship forms with your minimum £30 sponsorship money to the addressbelow or on the day. If your sponsorship money has been raised via justgiving then please bringalong a screen print of your sponsorship page.

• This sponsorship form must be returned to DAAT together with alldonations. Your donations must match the total on this sponsorship form.

• All cheques must be made payable to ‘BBC Radio Devon Air Ambulance Appeal’.

Thank You

Devon Air Ambulance Trust, 5 Sandpiper Court, Harrington Lane, Exeter, EX4 8NS

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