2021 NEW MEMBERSHIPS | HAMILTON BMX CLUB

This online form is for new memberships to our club for 2021.

- Step 1 of 9

1. Riders Name: *

First

Last

For new riders joining Hamilton BMX Club. Membership is annually 1st January 2021 to 31st December 2021. ATTACHMENTS REQUIRED: All new riders must provide a copy of their birth certificate or passport & a completed 2021 BMX NZ Licence form (see forms). If rider is 16 yrs or older they must complete & sign themselves.

Membership Options: *

2021 Sprocket
2021 Challenge/Championship
2021 Regional
2021 Strider

· Number Plate: Must have Club Abbreviation HN 25mm, Challenge - Male yellow plate with black numbers, Female blue plate with white numbers, Cruiser 24" - ALL red plate with white numbers. Plate numbers can be any number between 51 and 999.

2020 Club Levy

2021 Club Levy
Additional membership same family

per family - if you are joining another member of your family this is not required.

2021 Associated (1 member)

2021 Associated (2+ members)

Two or more members of the same family. Rider must be affiliated to another BMX Club in New Zealand. Associated members are entitled to: compete in the Hamilton BMX Club's Club Champs, sprocket training where applicable, to partake in Club gate nights, to the Hamilton BMX Club night fee with the reduction for other family members, concession cards are available. Associated Members are not entitled to become holders of Hamilton BMX Club's perpetual trophies.

What club are you affiliated to?

Cambridge CB
Te Awamutu TA
Paeroa POA
Te Kuiti TKT
Other

Bike Number Plate & Club Prefix:

please supply your bike number plate & club prefix if marked as other above.

Amount: *

$ 0.00

Request/check availability of bike plate no:

For challenge/championship or club membership.

Racing: *

20"
Cruiser

Health & Safety: *

Does rider have any health concerns?

Health & Safety:

Health Concerns
Allergies

If yes please provide details.

Health & Safety Details:

Health Concerns/Allergies/Dietary Requirements (whether food/insect/or other).

File Upload

Click or drag a file to this area to upload.

Riders Birth Certificate or Passport required either attach or supply at Club Night/email.

File Upload

Click or drag a file to this area to upload.

2021 BMXNZ Licence Form signed required either attach or supply at club night/email.

Required Forms

Supply at club night
Supply via email hamiltonbmx@xtra.co.nz

Riders Name:

2. Riders Name:

First

Last

Membership Options:

2021 Sprocket
2021 Challenge/Championship
2021 Regional
2021 Strider

2021 Associated (2+ members)

What club are you affiliated to?

Cambridge CB
Te Awamutu TA
Paeora POA
Te Kuiti TKT
Other

Bike Number Plate & Club Prefix:

please supply your bike number plate & club prefix if marked other as above.

Amount:

$ 0.00

Request/check availability of bike plate no:

For challenge/championship or region membership.

Racing:

20"
Cruiser

Health & Safety:

Does rider have any health concerns?

Health & Safety:

Health Concerns
Allergies

If yes please provide details.

Health & Safety Details:

Health Concerns/Allergies/Dietary Requirements (whether food/insect/or other).

File Upload

Click or drag a file to this area to upload.

Riders Birth Certificate or Passport required either attach or supply at club night/email.

File Upload

Click or drag a file to this area to upload.

2021 BMXNZ Licence Form signed required either attach or supply at club night/email.

Required Forms

Supply at club night
Supply via email hamiltonbmx@xtra.co.nz

3. Riders Name:

First

Last

Membership Options:

2021 Sprocket
2021 Challenge/Championship
2021 Regional
2021 Strider

2021 Associated (2+ members)

What club are you affiliated to ?

Cambridge CB
Te Awamutu TA
Paeroa POA
Te Kuiti TKT
Other

Bike Number Plate & Club Prefix:

please supply your bike number plate & club prefix if marked other as above.

Amount:

$ 0.00

Request/check availability of bike no plate:

For challenge/championship or club membership.

Racing:

20"
Cruiser

Health & Safety:

Does rider have any health concerns?

Health & Safety:

Health Concerns
Allergies

If yes please provide details.

Health & Safety Details:

Health Concerns/Allergies/Dietary Requirements (whether food/insect/or other).

File Upload

Click or drag a file to this area to upload.

Riders Birth Certificate or Passport required either attach or supply at club night/email.

File Upload

Click or drag a file to this area to upload.

2021 BMXNZ Licence Form signed required either attach or supply at club night/email.

Forms required

Supply at club night
Supply via email hamiltonbmx@xtra.co.nz

4. Riders Name:

First

Last

Membership Options:

2021 Sprocket
2021 Challenge/Championship
2021 Regional
2021 Strider

2021 Associated (2+ members)

What club are you affiliated to ?

Cambridge CB
Te Awamutu TA
Paeroa POA
Te Kuiti TKT
Other

Bike Number Plate & Club Prefix:

Please supply your bike number plate & club prefix if marked as other above.

Amount:

$ 0.00

Request/check availability for bike plate no:

For challenge/championship or club membership.

Racing:

20"
Cruiser

Health & Safety:

Does rider have any health concerns?

Health & Safety:

Health Concerns
Allergies

If yes & please provide details.

Health & Safety Details:

Health Concerns/Allergies/Dietary Requirements (whether food/insect/or other).

File Upload

Click or drag a file to this area to upload.

Riders Birth Certificate or Passport required either attach or supply at club night or email.

File Upload

Click or drag a file to this area to upload.

2021 BMXNZ Licence Form signed required either attach or supply at club night/email.

Forms required

Supply at club night
Supply via email hamiltonbmx@xtra.co.nz

Parent/Guardian Details:

Or rider to complete if over 16 yrs old

Name *

First

Last

Address: *

Phone No:

Mobile No: *

Email *

Confirm Email

Further details/comments:

Permission to include riders/family in photos, media etc... *

Additional Items:

Club Night Concession Cards (members 10 nights )

$20 (10 club nights @ $2) Non Refundable

Additional Club Night Concession Card

Additional Club Night Concession Card

Sprocket Training Concession Card (10 sessions)

$20 (10 sessions @ $2) Non Refundable

Additional Training Concession Card

Bike Number Plate

The club has bike number plates available for challenge or club members @ $10 ea.

Bike number plate

The club has bike number plates available for challenge or club members @ $10 ea.

Amount:

$ 0.00

Volunteering/Support:

Set Up
Shop
Cooking (hot chips)
BBQ
Club Night Registration
Assist with striders/set up cones
Call Up
Gate
Marshalling
Finish Line
Hire Bikes & Helmets
Points Hut
Striders
Clean Up

As a condition of membership, each family will be required to help the club on club night , events &/or training. Please indicate which area/s you would like to do.

Support our Club - Sponsorship, Advertising, Donation:

Would you like to Sponsor/Donate to the club ? *

Family Sponsor/Donation

As given in Parent/Guardian Section

Company Sponsor/Donation

Company

Company Details:

please provide company details e.g. address, email, ph

Annual Sponsorship/Advertising:

Annual advertising on Administration Building
Annual advertising on gate (to check availability)
Annual advertising using feather flag

The club is offering annual advertising options. Cost of the advertising is $200.00 plus GST per annum for 900 x 800 space for board or gate or feather flag. The advertiser must supply their own advertising & board. (you can purchase multiple areas). The advertiser is also published in our event programmes, website & social media pages.

One off set up of advertising:

ACM Board 900 x 800
Feather Flag 2.4m double sided print

Package Deal - Annual Sponsorship/Advertising:

Package Deal - Annual Advertising on Administration Building

Package Deal on annual advertising on our administration building - includes advertising material on ACM board 900 x 800 space (advertiser to provide club with material for printing). Cost is $345.00 plus GST per annum. The advertiser is also published in our event programme, website & social media pages.

Sponsorship/Donation:

Annually
Donation
Services
Products
Annual Back to Back Meeting Oct/Nov
Age Group (min $50 plus GST)

Specific Age Group is sponsorship for our Back to Back Meeting November 2019 or 2020, where you will be included in our power point, banner at club rooms, website & social media pages.

Donation Amount:

Please indicate your sponsorship/donation amount.

Amount:

$ 0.00

Comment, Details, Requirements:

Please supply any details e.g.. specific age group that you would like to sponsor on our Annual Back to Back Meeting Oct/Nov, products, services you wish to provide.

File Upload

Click or drag a file to this area to upload.

File Upload

Click or drag a file to this area to upload.

Company Logo

File Upload

Click or drag a file to this area to upload.

Business Card

Payment method: Bank Account 03 0314 0215610 00 Reference Surname *

Direct Credit
Eftpos @ club rooms
Cash @ club rooms

Postal Address: P O Box 1251, Waikato Mail Centre, Hamilton 3240

Total Amount:

$ 0.00

Note: 2021 Club Fees are $50.00 per rider except for the first three riders from the same family (excludes strider & associated), which is calculated. Maximum of $150.00 per family. Membership will be processed once payment is received. Bank Account 03 0314 0215610 00 Hamilton BMX Club Reference: Surname

Accept Terms & Conditions: *

By submitting this form you accept the clubs disclaimer & declaration & authorise Hamilton BMX Club to submit your membership on your behalf to BMX NZ if applicable, all riders that have previously held a BMX NZ licence continues to accept the terms & conditions of BMX NZ. Disclaimer: The Hamilton BMX Club Inc accepts no responsibility whatsoever for damage or injury of any nature to any person or property whilst participating in any activity organised by and under its control. Declaration: Privacy Act July 1993. All members need to be aware that the above information has been collected and will only be used for the efficient administration of the club. Details will only be forwarded where the committee sees fit and only after members have been notified, e.g.. for sponsorship purposes. In completing this form the rider/s or in the case of a minor, the parents or representatives of the rider/s, hereby acknowledge that they have read and understood the nature and effect of this disclaimer and declaration.

Phone