PLEDGE FORM

I would like to sponsor

(Peter Samways)

to take part in Enduro India by donating the following amount:

Your name:

(please print)

Address:

Postcode:

If commercial sponsorship please complete the following:

(please print)

Company:

Company Address:

Postcode:

Your Job Title / Position:

I enclose cheque / postal order for £____________________________ (pounds sterling)

Signed:

Date:

Receipt required: YES / NO

Enduro India will donate a minimum of £1,500 per person attending the Rally to charities in the following proportions: 40% to each

of Adventure Ashram and Wildlife Conservation Society & 10% to each of World Wide Fund for Nature and Rainbow Trust.

In addition where participants raise more than £4,500 a further 60% of any such amount will be donated to the charities as above.

Thank you for supporting The Rainbow Trust Children’s Charity (reg. Charity No: 1081247), Wildlife Conservation Society India

(reg. Charity No: 13-1740011), Adventure Ashram (pending registration), World Wide Fund for Nature (reg. Charity No: 1070532).