Charity Race Night registration form

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Moore Thompson Charity Race Night registration

Yes please reserve places at your Charity Race Night on Thursday 8 June
At a cost of £12 each or £100 for a table for ten.
Name:
Company:
Email:
Telephone:

Sponsorship

 
Yes – I would also like to sponsor horse(s) at a cost of £10 each.
Please enter the name you would like to give your horse(s)
I would also like to sponsor a race  Yes No
[Name of organisation]
We will contact you to arrange an advertisement in our race night programme. Please provide the name and contact details of the relevant person within your organisation:
Name:
Telephone:
TOTAL AMOUNT PAYABLE
Please insert name of payee as it appears on your bank account details so that we can track your payment
I confirm that I have today posted a cheque for £ made payable to The Moore Thompson Charity Fund CIO, sent for the attention of Louise Bacon, Moore Thompson, Bank House, Broad Street, Spalding, Lincolnshire, PE11 1TB  Yes No
I confirm that I have today sent a £ payment via BACS to the Moore Thompson Charity Fund CIO sort code 20-80-78, account number 73422186.  Yes No

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