Springston Trophy 2023 - Rider Dispensation Form

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This form is to be completed by the head coach of any rider entered in a team or the Available Rider Register that needs dispensation for their rally count requirements. Please ensure that as the head coach you are familiar with the NZPCA Competition Rally Requirement as per rule 15.4 in the general Regulations. Please ensure you are also familiar with rule 15.6 Dispensation before you complete this form.

Email *

Head Coach Name *

Head Coach Contact Number *

Rider Name *

Reason for Dispensation required? *

District Commissioner Name

District Commissioner Contact number *

District Commissioner Email Address *

As the Head Coach of this rider, you agree to the following: *

You have contacted your District Commissioner regarding this rider

Your District Commissioner has granted dispensation for one rally for this rider

With this dispensation, your rider now meets the rally requirements as per NZPCA rule 15.4 and is eligable to compete at COPC Springston Trophy 2023

Required

A copy of your responses will be emailed to the address you provided.

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