Annual Race Licence Application – Jet Ski Racing New Zealand

Name *

First

Last

Address *

Email *

Date of Birth

Required for all riders aged under 18 years.

Ski Number/s *

Race Numbers must be confirmed by the Executive and must comply with legibility criteria as specified in the Rulebook. If you have more than one number please separate them with a comma.

Council Registration Number/s *

Council Registration Number/s must be registered with Local Harbour Master. Proof may be required.

Medical Declaration

I declare that I am not aware of any medical conditions that may affect my ability to safely participate in race events
I declare that I suffer from the following medical conditions.

Known Medical Condition/s and controls/medications

Indemnity Clause

I understand that motorsport is hazardous and that by participating in the event stated below I am voluntarily exposing myself to the risk of personal injury or death. I hereby indemnify Jet Ski Racing New Zealand (the Association), each and every member of the Executive, fellow competitors, staff employed by, volunteering or working under the authority of the association and promoters or partnering sport codes against any claims or demands whatsoever which may arise from or in respect of my participating in the event, including but without limitation, any claims in respect of personal injury (whether wholly or partially covered by the provisions of the Accident Compensation Act or otherwise) any claims in respect of property, whether owned by me or any other person and whether relating to boats and their equipment or any property owned by authority and I AGREE and CONFIRM that the associations or their subsidiaries shall not be in any way liable for any such claims whether made by me or any persons under my name or my authority, or by any action of mine. I agree to adhere to the rules of the Association and will follow safety instructions issued by the officials.

Annual Licence Application Checklist *

I am a paid up member of the club
I have completed the Licence Application Form AND agreed to the Indemnity Clause
I have paid the Annual Licence fee of $150
I have completed the medical declaration above.

Please ensure you have thoroughly read ALL the rules paying particular attention to the overall safety rules and rules specific to your race class. If you have any queries or require clarification, please email info@jetskiracingnz.com. Payment must be made before the license is issued to Jet Ski Racing New Zealand, Bank Acct. 02-0112-0141545-025). Use last name and "license fee" to identify payment.

Parental Permission

If I am aged over 15 years and under 18 years of age, my parent has applied on my behalf. (Please scan photo ID of parent.)

I declare the following: *

That I am of sound mind and do not suffer from any medical condition or disability that may make it unsafe for me to compete in jet ski events
That I will never be under the influence of drugs or alcohol at the time of participating in events
That I have read this form and understand its contents
That I am over 18 year (if not, a parent or guardian must fill out this form and be present)

Agreement *

In submitting this form I hereby declare, in the absence of my signature, that the information above is true and correct. I am aware that this licence is valid for racing within New Zealand only. I agree that by applying for a Race Licence I will abide by all the rules, regulations and laws laid down by Jet Ski Racing New Zealand, relevant local bodies and New Zealand statute.