Register for an Event

Field marked * below are required fields

Event Name or Ref:* KiwiSport Funding Meeting
Event Date:* 17-3-2010
Title:*
Name:*
Address*
Email:*
Phone:*
Mobile:
Sport:*
Club/Organisation:*
Position/Role:*
Special Needs or Requirements:*
Methods of Payment:

Cash, Cheque (payable to Sport Waitakere) or using an internet banking transaction (A/C name: Sport Waitakere A/C No: 06 0153 0378119 00). Please ensure that your internet banking transaction uses the reference number, or event name where a reference number isn't available.
Cancellations/Withdrawals:

Notice of a withdrawal from a course must be received in writing at least 5 working days prior to the start of the course for a full refund. No refund will be provided with less than 5 working days notice.
Sport Waitakere reserves the right to cancel workshop dates if course registration numbers are less than 15, in this instance a full refund will be given.
In the unforeseen and/or unlikely event that Sport Waitakere will have to cancel this workshop, please provide a bank account number that we can deposit your Prepaid Registration Fee (if Prepaid).
Bank Account Number:
Privacy Act:

I consent to the collection of the above details to be stored in the Sport Waitakere database. I acknowledge my right to access and correct this information. This consent is given in accordance with the Privacy Act 1993.
Yes I have read the Privacy Act and I accept:  *
 
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