REGISTRATION FORM ~ 2022 Sprint National Champs 22-24 April
22-24 April 2022 @ Lake Karapiro

Division Fees
- Novice, Tyros, U14 ~ $60
- U16, U18 ~ $85
- Open/Masters ~ $100

Races include:
- Novice men/women: K1 100m 200m, 500m
- 12&U men/women:  K1 100m, 200m 500m, mixed K2 200, mixed K4 200
- 14&U men/women: K1 200m, 500m, K2 200m, 500m, mixed K4 200m, 500m
- 16&U men/women:  K1 200m, 500m, K2 200m, 500m, K4 200m, 500m
- 18&U, Open, Masters Women:   K1 200m, 500m, K2 200m, 500m, K4 200m, 500m
- 18& U, Open Men:  K1 200m, 1000m, K2 200m, 500m, K4 200m, 500m
- Open Men K1 500
- Masters Men 35-44, 45-54, 55+:   K1 200m, 1000m
- Masters Men:  K2 200m, 500m, K4 200m, 500m
- Junior (16&U) Mixed K2 200m, K4 200m, 100m relay
- Senior (17&over) Mixed K2 200m, K4 200m, 100m relay

* PLEASE NOTE that you can enter event across multiple age groups, however you will be charged the fee of the highest age group entered.
PLEASE COMPLETE YOUR ENTRY BY 3 APRIL

Any questions contact Kirsty Elmiger at 0211320818 or info@northshorecanoeclub.org.nz

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Email *
Full Name
Date of Birth
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YYYY
Email address
Mobile Number
PARENTAL CONSENT (U18's) - If you are U18 do you have parental consent to participate in this event? Please respond below YES / NO and Provide your parent/ guardian's name and email address so we can email them a consent form to complete thank you.
Medical Condition - Please detail any medical condition we need to be aware of.
Emergency Contact Name & Mobile Number
Age Group
Race Options - Please tick all races you wish to enter, including team boats you'd like to be considered for. You can add preferred team boat partners in the next question comment box. *PLEASE NOTE that you can enter events across multiple age groups, however you will be charged the fee of the highest age group entered.
Team Boats Partners - Please detail below any preferred team boat partners for which races.
Club Boat & Trailer Use - Will you be using a club boat (K1 or Team Boat) for Nationals or requiring a spot on the trailer for a private boat? Please note this will incur a $20 charge (this helps towards petrol costs of towing)
Clear selection
CLUB SINGLET - Do you need a Club Singlet? $65
CLUB HOODIE ~ Do you want a club hoodie? $75
CLUB FACE MASK - Do you need a Club Face Mask? $20
Clear selection
VOLUNTEERS - Are you available to volunteer to help with any of the roles that need to be covered during the event? eg Team Manager, First Aid, Boat Control or other. Please comment below.
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