Second Stoke Mandeville In2 Sport Camp Saturday 29 th and Sunday 30th November2014 Stoke Mandeville Stadium, Aylesbury The In2 Sport Camp is for those aged 18+ with a physical impairment. The camp will provide the opportunity to receive coaching in a number of sports. Provisional sports include archery, basketball, cue sports, fencing, powerlifting, rowing and table tennis. Timings for the weekend are Saturday 09:30 16:45. There will be social activities from 19:00 21:00. Sunday 09:00 13:00. The entry fee is: Saturday and Sunday 15.00 Saturday only 9.00 Sunday only 7.00 Please note that the entry fee is per person and also applies to anyone attending with you. Lunch will be provided free of charge. Breakfast and dinner are available at an extra charge. There is a café and vending machines at the Stadium. Accommodation will be available at an extra charge per room, on Friday and Saturday night at the on-site Olympic Lodge. For further information please contact WheelPower on 01296 395 995 or e-mail stewart.jeeves@wheelpower.org.uk Entry forms can be completed and returned by post or email by Friday 21 st November. We look forward to welcoming you to the Camp. Stewart Jeeves Sports Development Officer, WheelPower October 2014 1
Map of Aylesbury A marks Stoke Mandeville Stadium Please note that the train station located near the centre of the map is Aylesbury Station. The station northwest is Aylesbury Parkway Station. Stoke Mandeville Stadium Guttmann Road Stoke Mandeville Aylesbury Buckinghamshire HP21 9PP 2
Travelling to Stoke Mandeville Stadium by train Please note that all stations shown are wheelchair accessible 1. Aylesbury Station, Aylesbury, HP20 1RU 8 minutes driving distance to Stoke Mandeville Stadium A bus runs from the station to Stoke Mandeville Hospital, a 10 minute walk to Stoke Mandeville Stadium Wheelchair accessible taxis: Hackney cabs Please visit www.travelinesoutheast.org.uk for information on bus times from Aylesbury Rail Station to Stoke Mandeville Hospital. 2. Aylesbury Vale Parkway, Aylesbury, HP18 0PS 16 minutes driving distance to Stoke Mandeville Stadium Wheelchair accessible taxis: ABC Taxis 01296 423232 Falcon Taxis 01296 580000 Tiger Cabs 01296 431412 Please visit www.travelinesoutheast.org.uk for information on bus times from Aylesbury Vale Parkway to Stoke Mandeville Hospital (Please note that buses on this route may not all be wheelchair accessible). 3. Milton Keynes Central, Milton Keynes, MK9 1LA 40 minutes driving distance to Stoke Mandeville Stadium The 150 bus run from MK Central to Aylesbury Bus Station, a 10 minute taxi ride to Stoke Mandeville Stadium Wheelchair accessible taxis: Skyline Taxis 01908 222111 Raffles 01908 222222 Bill s Minibuses 01908 613000 Please visit www.arrivabus.co.uk for information and accessibility for buses from MK Central to Aylesbury Bus Station. 3
PLEASE COMPLETE LEGIBLY Title: Entry Form First name: Surname: Address: Post Code: Telephone: D.O.B: Age: Email: Brief details of impairment: Do you have any allergies / dietary requirements? How did you hear about the WheelPower In2 Sport Camp? What is your level of mobility when playing sport? Ambulant Manual wheelchair Powered wheelchair How regularly do you participate in disability sport? At least once a week Monthly Fortnightly Never Would you like to be kept informed about future WheelPower events? 4
Contact details of anyone accompanying you at the camp Title: First name: Surname: Address: Post Code: Telephone: Mobile Number: Email: Do you have any allergies / dietary requirements? Medical / Photo consent GP s Name: GP s Address: Post Code: Telephone: Do you give consent to receive emergency medical treatment? Yes Signature: Do you give consent for your photo to be used for promotional purposes? Yes No Any other information: 5
Sports at the In2 Sport Camp Please tick the sports in which you would like to take part at the In2 Sport Camp: Archery Basketball Fencing Snooker/Pool Rowing Powerlifting Table Tennis Accommodation at the In2 Sport Camp Do you require accommodation at the camp? Date of arrival: / / Date of departure: / / Name(s) for accommodation: Special requirements: 6
Payment Form Fees must be paid in full with the Entry Form and received by Friday 16 th May 2014. Registration cannot be confirmed until payment has been received. Refunds cannot be issued unless 1 week s notice of cancellation is received prior to the start of the event unless there are exceptional circumstances. Entry fee *Price per person Accommodation & Meals *Accommodation = price per person. Meals = price per person. Cost Amount Total Saturday and Sunday 15.00 Saturday only 9.00 Sunday only 7.00 One night 12.50 Two nights 25.00 Breakfast (per meal) 3.00 Dinner (per meal) 5.00 Overall Total Payment Options Cheque / Postal Order made to WheelPower Enclosed with this entry form is a cheque for Credit / Debit card Please complete the following in block capitals: Card number: Name on card: Expiry date: Issue no: Security code (last 3 digits below the magnetic strip): Please debit my account sterling in payment Signature: Date: Thank you, we look forward to seeing you at the In2 Sport Camp 2014 7