Manawatu Triathlon Club Membership Form

Please note that your membership of the club will not be confirmed until we have received your payment of membership fees either by Cheque or by Internet Banking.

Details on how to pay your membership fees will be emailed to you once you have submitted this form

Membership type: *

Senior $20

School Student (under 19) $15

Family $40 (with school age children)

Surname: *

First Name: *

Date of Birth: *

TriNZ Membership: *

No

Yes

Optional and free, runs until 31 October 2012

If you are registering as a family please fill in the following section.

Phone: *

Mobile:

Address: *

Email: *

Are you interested in being on the committee:

No

Yes

Are you interested in assisting with races:

No

Yes

Are you paying by internet banking or cheque?:

Internet banking

Cheque

Club rules:

Club Champs: must be a financial club member, have membership at least one calendar month prior to club champs. Have competed or assisted with marshalling no less than 2 races (within the series) prior to club champs
Competitors enter all events at their own risk and acknowledge that they must obey all road rules. Keep left at all times; obey all Marshall and Race Director’s instructions.
No bike drafting allowed.
Be considerate to fellow competitors.

DECLARATION:

I (we) enter at my (our) own risk and hereby release and fully indemnify the event organisers, their officers, volunteers, sponsors or any other party associated with the event of any liability, cost, action, claim, financial or otherwise. I (we) give permission for our name and photo(s) to be used for any club promotional activity on the club website, Facebook or other place as deemed fit by the Manawatu Triathlon Club executive committee

I agree to the Club rules and make the above declaration