Trev Terry / Yamaha, Round 2 & 3, Entry Form

Race Entry

All riders must complete Race Entry before any race event. Please complete this online, if possible, and make payment by direct debit before race day.

Indemnity

Each of the official statements on the form must be confirmed by the rider, as a requirement of race entry.

Note: IF YOU ARE UNABLE TO HONESTLY CONFIRM EVERY STATEMENT PLEASE DO NOT PROCEED WITH YOUR ENTRY.

Riders may be required to submit to a drug test at any event.

Name *

First

Last

Address *

Phone number *

Email *

D.O.B

To be completed if 18 years or under. Riders must be over 15 years of age in order to compete.

Round Entering *

Both 2 & 3
Round 2 only
Round 3 only

Race Number *

Checkboxes

Got more than 1 Ski or entering additional class?

Membership Status *

Fully Paid Member
Paid in addition to race entry

Racing Registration Fees *

2 day entry: $200 early bird (by 18 Jan)
Single day entry $120 early bird (by 18 Jan)
Additional class: $60 early bird per day
$60 Watercross (Lunchtime Enduro)
2 day entry: $250 (after 18 Jan)
Single day entry: $150 (after 18 Jan)
Additional class $75 (After 18 Jan)

Membership & License Fees *

Day licence - $40.00 (new riders only)
Annual licence - $150 (paid 1 time pa)
Single club membership - $20.00 (1 time pa)
Family club membership - $30.00 (1 time pa)
N/A - I'm all paid up!

Riders are entitled to race at just three events prior to becoming a member. To qualify for the Early Bird discount the Entry Fee and Day licence must be paid by the Thursday evening prior to the event. All riders must purchase the relevant licence in addition to the entry fee. To qualify for an Annual Licence you must complete a full medical examination.

I declare the following: *

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.
I am of sound mind and do not suffer from any medical condition or disability that may make it unsafe for me to participate in jet ski events
I am not under the influence of drugs of alcohol at the time of participating in this event
I have read this form and understand its contents

Jetski Declaration *

I confirm that my jetski meets all the requirements of the classes entered. If found to not be the case, any prizes and points awarded to me will be returned and I will be disqualified.

I further declare

I am over 18 years (Minimum racing age is 15. If under 18, a parent or guardian must complete the section below and be present at the event.)

Parent or Guardian Agreement

In submitting this form, I as the parent or guardian of the rider hereby declare, in the absence of my signature, that the rider has permission to race and the information above is true and correct. l abide by all the rules, regulations and laws laid down by Jet Ski Racing New Zealand, relevant local bodies and New Zealand statute.

Parent/Guardian Name

First

Last

Parent/Guardian Phone

Rider Agreement *

In submitting this form, I as rider hereby declare, in the absence of my signature, that the information above is true and correct. I agree that by applying to race, 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.

PAYMENT DETAILS

Payment made via bank Transfer

EFTPOS IS NOT AVAILABLE. Bank Details: Jet Ski Racing New Zealand, Account No. 02-0112-0141545-25.

Name