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HIBISCUS COAST ATHLETICS CLUB
http://www.sportsground.co.nz/hibiscusathletics

Registrations Open

2010/11 Registration Form

Registrations have opened for the 2010-2011 season, however, numbers are limited for every age group.
To avoid disappointment, please register and pay for your child, or children, early. Payments can be made direct into our bank account (details below)

For details of this season's subscriptions, please refer to Club Membership Fees page or contact us for more information. Uniform costs are additional to membership fees for athletes aged 5 to 14. Budding athlete t-shirts for ages 3-4 cost $11; t-shirts for ages 5 & 6 cost $11; and singlets for ages 7 -14 cost $29 each.

When making payments for membership fees to Hibiscus Coast Athletics Club after registering online, please include the Confirmation Reference Number provided. Include name and phone number on cheques. If you prefer to make a direct transfer, our club account number is 12-3084-0257041-00. Please also include your surname and phone number as a reference.
Thank you.

Fields marked with are required.

Role
PlayerCoachReferee/Umpire
OfficialCommitteeManager
Volunteer
First name
Last name
Email address
Date of birth
Sex
Address
Suburb
Town/City
Parent/guardian Name
Parent/guardian Mobile
Parent/guardian Home phone
Existing member
Emergency contact name
Emergency contact relationship
Emergency contact phone
Emergency contact mobile
Does child require a club singlet
Singlet size 4
Singlet size 6
Singlet size 8
Singlet size 10
Singlet size 12
Singlet size 14
Any Relevent Medical Condition
Number of Siblings to be registered
Age as at 31st Dec 2010
Payment by direct credit (details)
Payment by chq (details)
Verification
Please enter the following text in the space below

WHY?
Terms and Conditions

STATEMENT OF INTENT
I have read and agree to abide by the following statements:
I understand that one of the aims of the Hibiscus Coast Athletics Club is to create a 'family' atmosphere.
I accept that the club requires parents/caregivers of children aged under seven years to remain on site at all times during club nights.
I also understand that the club encourages parents/caregivers of all children to remain on site during club nights whenever possible.
I agree to help on at least two club nights throughout the season.

I accept
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