NZ Kiteboard Nationals Entry Form
  1. This competition is open to New Zealand Citizens and residents (proof may be required) Entry is by pre registration only, by the completion of this form and payment of fee at $120.00 each Payment and registration must be received no later than the 6th October 2011(Two weeks prior). By submitting this form you hereby agree unconditionally to pay the entry fee.

  2. Competitor Details

  3. First Name*
    Please fill in your first name
  4. Surname*
    Please fill in your last name/surname
  5. Street*
    Please fill in your street
  6. City*
    Please fill in your city
  7. Date of birth*
    Please fill in your first date of birth
  8. Email address*
    Please fill in your email address
  9. Mobile Number*
    Please fill in your mobile number
  10. Phone number
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  11. Other phone number
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  12. Emergency contact*
    Please fill in a number to contact in case of an emergency

  13. Category Details (please tick the box or boxes that apply to you. Free style entrants are automatically eligible for freeride )

  14. Category
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  15. T-Shirt (please choose your size)

  16. T-Shirt Size*
    Please select your T-shirt size
  17. Your entry fee includes the following:
    Prize Giving Dinner (3 course Smorgasbord), Social with Rugby World Cup Final at the Buretta Park Motor Inn, Tauranga on Sunday 23rd at 6.30 pm till late.
    FOR ADDITIONAL FAMILY AND FRIENDS PLEASE SELECT YOUR REQUIREMENTS BELOW
    Cost is $20.00 per person for adults children over 12s yrs / 12 yrs and under $1.00 per yr of age.
    (do not include yourself - included in entry fee)

  18. Social Function Details

  19. Additional Adults ($20 per)
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  20. Children over 12yrs ($20 per)
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  21. Age of 1st Child 12 yrs and under
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  22. Age of 2nd Child 12 yrs and under
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  23. Sub Total
  24. $ for extra diners at social function
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  25. Note: This may be paid on the night but pre-registration insures you a space.
  26. Your own entry fee
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  27. Calculate Total
  28. Total being paid*
    Please click the calculate buttons above to find out the total fees to be paid
  29. Payment Method*
    please select one
  30. Antispam
    Antispam
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  31. Register