Bike Manawtau Track Carnival

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Who are you registering? Choose one Yourself

Team name   First name   Last name   Email address   Date of birth DD 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31    MM 01 02 03 04 05 06 07 08 09 10 11 12       YYYY 2021 2020 2019 2018 2017 2016 2015 2014 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 1941 1940 1939 1938 1937 1936 1935 1934 1933 1932 1931 1930 1929 1928 1927 1926 1925 1924 1923 1922    Gender -- Male Female   Club name Other     CNZ Licence # Other     Phone #   Address   Emergency contact name   Emergency phone #   Category Choose one Elite (19+) Masters Cat 1 (35-44 years) Masters Cat 2 (45-54 years) Masters Cat 3 (55+ years) Senior (19-34 years) U13 (12 years & under) U15 (13 - 14 years) U17 (15 - 16 years) U19 (17 - 18 years)

I am able to provide a volunteer helper on the day  * NoYes   In preparation for the traffic light system, Are you double Vaccinated for Covid?  * NoYes   If you have selected "No" please select from the following  * Choose one Under the age of 12 Exempt with proof Prefer not to disclose   Are you willing to show your vaccine passport if required?  * Choose One Yes No

Please review the waiver provided by the event organizer and click the check box below to accept it. Print waiver The person whom signs the registration form, acknowledges that…… - I am aware of the dangers of track cycling/ racing and compete in the event at my own risk. - I have read and understood any written race instructions and acknowledge that all instructions, whether written or verbal, are clear and unambiguous. Take careful note of the pre-race briefing given to you by the starter. - The organisers have done their best to make the event as safe as they can. - I must obey all the track rules. - The decision of the Commissaire is final and discussions will not be entered into. - If I am involved in an accident, I will not seek to blame or make a claim against the organisers, nor will I assist anyone else in making such a claim. - If I have any concerns with the race organisation, I will raise them with the organiser first. I will not raise them with any other person, recognising that I will only jeopardise the continuation of the event. DECLARATION I agree to abide by the above event terms and conditions. I agree to follow all rules and marshal's directions. I accept that all handicaps, rider grading and event setup will be solely at the discretion of the event director. I acknowledge that the event director or club officials have at their discretion the right to disqualify or remove points from any rider deemed to have infringed any Terms, Conditions, or Rules as specified. In addition I accept that any rider who behaves in a reckless, abusive, dangerous or socially inappropriate way, may also be sanctioned. I agree that the Bike Manawatu can retain my name and contact details and that they can be supplied to the Ministry of Health should they need to contact trace to support the governments national health response to Covid-19. I accept the terms of the waiver Name of parent or guardian who approves this activity