Sprocket Training Enrolment 2018/19 - Step 1 of 51. Riders Name: *FirstLastMembers to complete to enrol for 2018/19 training. Sprocket training L1 & L2 - if you are a new rider to our club we invite you to attend 2 sessions prior to becoming a member.Level: *Level 1 (sprocket, new riders)Level 2 (mid range)Health & Safety: Health ConcernsAllergiesTick box if yes & provide details.Health & Safety Details:Health Concerns, Allergies or Dietary Requirements (whether food,insect or other).NextRiders Name:2. Riders Name:FirstLastLevel:Level 1 (sprocket, new riders)Level 2 (mid range)Health & Safety: Health ConcernsAllergiesTick box if yes & provide details.Health & Safety Details:Health Concerns, Allergies or Dietary Requirements (whether food,insect or other).PreviousNext3. Riders Name:FirstLastLevel:Level 1 (sprocket, new riders)Level 2 (mid range)Health & Safety:Health ConcernsAllergiesTick box if yes & provide details.Health & Safety Details:Health Concerns, Allergies or Dietary Requirements (whether food,insect or other).PreviousNext4. Riders Name:FirstLastLevel:Level 1 (sprocket, new riders)Level 2 (mid range)Health & Safety: Health ConcernsAllergiesTick box if yes & please provide details below.Health & Safety Details:Health Concerns, Allergies or Dietary Requirements (whether food,insect or other).PreviousNextParent/Guardian Details:Name *FirstLastAddress:Please provide address details if changedPhone No:Mobile No: *Email *EmailConfirm EmailTrusted Person Details:Name: *FirstLastA trusted person is like a 'next of kin' and is someone a coach can contact in the unlikely event of the Parent/Guardin falling ill or being injured during a training session.Trusted Persons Contact Numbers: *Mobile No:Further details/comments:Training Concession Card:Do you have a current training concession card ? *YesNoIf yes, please indicate below how many sessions you have left.Number of Training Sessions left on concession card.Purchase a training concession card:Training Concession Card (10 sessions) $20Concession Card can be used for all family members attending training.Payment Method: Bank Acc 03 0314 0215610 00 Hamilton BMX Club - Reference: Surname - TrainingDirect CreditTotal$ 0.00Bank Account 03 0314 0215610 00 Hamilton BMX Club Reference: Surname - Training Once payment is received you will be able to register your attendance for training on the night. Accept Terms & Conditions: *Accept By submitting this form you accept the clubs disclaimer, code of conduct & declaration. 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.PreviousNameSubmit
