Team Entry Form

1. Entry Form > 2. Payment Options > 3. Payment

 

You can enter online and pay securely using your Credit Card or PayPal account.

You must read and agree to the Rules and Regulations and Waiver before you can complete an entry.

Entries close on 31 December 2008. *Indicates required fields.

 

Team Details

Team Name: Required. *
Club Name: (if applicable)
Team Leader Name: Required. *
Category: Select. *

 

Team Member 1 - Swim

First Name: Required. *
Last Name: Required. *
Gender:
Are you a professional athlete?
Date of Birth: (dd/mm/yyyy)
Age on race day:
Phone:
E-mail: Required. *
Street Address:
City:
Postal Code:
Occupation:
Nationality:
Do you speak English?
If no, what language do you speak?
T-Shirt Size:
Do you have a medical condition?
e.g. asthma, high blood pressure, diabete etc?
If yes, please give details and any treatment or medication required:
Do you have any allergies?
If yes, please give details and any treatment or medication required:

 

Team Member 2 - Bike

First Name: Required.*
Last Name: Required. *
Gender:
Are you a professional athlete?
Date of Birth: (dd/mm/yyyy)
Age on race day:
Phone:
E-mail: Required. *
Street Address:
City:
Postal Code:
Occupation:
Nationality:
Do you speak English?
If no, what language do you speak?
T-Shirt Size:
Do you have a medical condition?
e.g. asthma, high blood pressure, diabete etc?
If yes, please give details and any treatment or medication required:
Do you have any allergies?
If yes, please give details and any treatment or medication required:

 

Team Member 3 - Run

First Name: Required. *
Last Name: Required. *
Gender:
Are you a professional athlete?
Date of Birth: (dd/mm/yyyy)
Age on race day:
Phone:
E-mail: Required. *
Street Address:
City:
Postal Code:
Occupation:
Nationality:
Do you speak English?
If no, what language do you speak?
T-Shirt Size:
Do you have a medical condition?
e.g. asthma, high blood pressure, diabete etc?
If yes, please give details and any treatment or medication required:
Do you have any allergies?
If yes, please give details and any treatment or medication required:

 

Arrival/Departure Date

Wanaka Arrival Date:
Wanaka Departure Date:

 

Estimated Times

Swim (hours/minutes) Required. *
Bike (hours/minutes) Required. *
Run (hours/minutes) Required. *

 

Personal / Team Accomplishments

 

 

Sponsors Information

From time to time our sponsors may have information that will be of interest to you.
Tick here if you do not want to receive any updates from our sponsors

 

Declaration

Please Tick. We have read and agree with the Rules and Regulations
Please Tick. We have read and agree with the Waiver