EXPRESSION OF INTEREST FORM

The Irish Pilgrimage Trust Cycle (IPTC), A Sponsorship Fundraising group of The Irish Pilgrimage Trust.

Expression of Interest Form – Sponsored Cycle to Lourdes, 23rd – 29th March 2024

Completion and submission of this form does not guarantee me a place on Cycle 2024

Name*

First NameLast Name

Address*

Street Address

Street Address Line 2

Address line 3Address line 4

Eircode/Postcode

Email*

example@example.com

Mobile Number*

I understand that if my application for registration is accepted I will be required to raise a minimum sponsorship of €3,000 and separately pay my own fare of €850 to cover transport to and from France and my accommodation and meals while on the Cycle to Lourdes. I agree that accommodation will be provided on a shared basis only.

Once this Expression of Interest is received an application form for registration will be provided so long as places remain available at that time. I agree that I will be required to pay a non-refundable deposit of €200 with my application for registration. If my application is accepted, the €200 deposit will be deducted from my fare.

I understand that Terms and Condition’s apply to this event.

Expression of Interest for a role with the 2024 Sponsored Cycle to Lourdes - Please select one of the following*

I wish to be considered as a Cyclist for Cycle 2024I wish to be considered for a role with the Support Crew Cycle 2024I wish to be considered for a driving role with Cycle 2024I wish to be considered for a Bike Mechanic role for Cycle 2024

In submitting this Expression of Interest Form I understand and agree that the Irish Pilgrimage Trust Sponsored Cycle to Lourdes 2024 edition is a limited event and can only cater for a restricted number of cyclists and support crew principally due to accommodation constraints, safety and management.

The Irish Pilgrimage Trust Cycle reserves the right to refuse or cancel any entry to this event without giving any reason for doing so. We reserve the right to establish a waiting list and to offer a place in the event of a place or role becoming available due to dropouts or cancellations. Everyone participating must pay their fare in full and raise the required sponsorship.

The Irish Pilgrimage Trust, Kilcuan, Clarinbridge, Galway, H914 W596

Charity Registration no 20009953 Revenue CHY 5992