Entry Form

Event Enquiries to: Mondo Kopua, mondo.enterprises@xtra.co.nz, ph. (03) 579 4807
Entry Enquiries to: Janette Holdaway, nzra.entries@gmail.com, ph. Ph. (03) 578 7137

Entries close 5pm Thursday, 10th March 2011. (Late entries will not be accepted)

Adult Entry Fee: $90 per person.
Junior Entry Fee: $45 per person (People under 23 on the first day of the event).

Bus from Picton: Alan Wilson will run a bus from Picton and return. See the details.

All information requested below must be completed.

Team Contact:
	Firstname:	Lastname:
	Street:		Town:	Postcode:
	Email:		Phone:	Entry fee:
Team Member 2:
	Firstname:	Lastname:
	Street:		Town:	Postcode:
	Email:		Phone:	Entry fee:
Team Member 3:
	Firstname:	Lastname:
	Street:		Town:	Postcode:
	Email:		Phone:	Entry fee:
Team Member 4:
	Firstname:	Lastname:
	Street:		Town:	Postcode:
	Email:		Phone:	Entry fee:
Team Member 5:
	Firstname:	Lastname:
	Street:		Town:	Postcode:
	Email:		Phone:	Entry fee:

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Team Category: (All team members must comply; age is on the first day of competition)
Gender:	Men	Women	miXed
Age Group:	Junior (under 23)	Open	Vet (40+)	SuperVet (55+)

Which event?	(Please - no switching between events after you have entered)
	24 hr championship		15 in 24hr

Total Entry Fees: $ If your browser does not calculate the total entry fee (because Javascript is not enabled) then please calculate it yourself and enter it manually

Select method of payment:

Direct credit to NZRA Account No. 03 0674 0197735 00. Please use the Team Contact's name as reference to identify your payment

Cheque payable to New Zealand Rogaining Association. Send to

NZ Rogaining Championships 2011
c/o Janette Holdaway
300 Vickerman St
RD 3
Blenheim 7273 Email: nzra.entries@gmail.com

Confirmation of entry: Your entry will be confirmed, after payment has been received, by posting it in the list of entrants.
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If you have any message for the organisers please type it here:

Note:

Each competitor must be a member of a Rogaining Association or an Orienteering Club, or must become a member of the NZ Rogaining Association (free), and hereby agrees to abide by the NZRA rules and Code of Conduct. These can be found at www.rogaine.org.nz where information and online membership are available. Your attention is drawn particularly to the condition of membership that you enter all events entirely at your own risk. All participants will be required to sign an indemnity that neither the Association, the organisers, nor the landowners will be held responsible for any accident or injury which may occur.

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I (the Team Contact) undertake to ensure all team members have seen or been fully advised of the written event briefing information distributed to me and available at www.rogaine.org.nz before the event.

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