Section 1 of 1
Surfing for Farmers - Registration Form
Email
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Surname
Surname
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Phone number
Phone number
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Occupation
Occupation
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Address
Address
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Region/beach
Region/beach
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Ahipara
Northland - Sandy Bay
Northland - Waipu Cove
Raglan
Waihi Beach
Mount Maunganui
Pauanui
Pukehina beach
Ohope
Gisborne
Tolaga Bay - Kaiaua Beach
North Hawkes Bay- Waimarama
Central Hawkes Bay
New Plymouth
Opunake
Whanganui
Foxton Beach
Marlborough/Kaikoura
Canterbury - Gore Bay
Canterbury - Sumner
Canterbury - Hickory Bay
Greymouth
Dunedin
Kaka point
Oamaru
Southland - Colac Bay
Wairarapa
Other…
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Medical conditions
Medical conditions
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Emergency contact
Emergency contact
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Emergency contact number
Emergency contact number
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Age Group
Age Group
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Under 20
21 -30
31-50
51-60
Over 60
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Gender
Gender
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Male
Female
Prefer not to say
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How did you hear about Surfing for Farmers? (If Facebook, which page/group?) Beef n lamb emails
How did you hear about Surfing for Farmers? (If Facebook, which page/group?) Beef n lamb emails
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I give permission for images of me to be taken and shared throughout the programme:
I give permission for images of me to be taken and shared throughout the programme:
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No
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I give permission for SFF to use my contact info for promotions and to contact participants in the case of cancellations etc- contact details wont be shared.
I give permission for SFF to use my contact info for promotions and to contact participants in the case of cancellations etc- contact details wont be shared.
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Electronic Signature
Electronic Signature
I hereby agree to abide by the decisions of the coaches and organisers. I release the organisers and coaches, from all liability from injury, loss or damages whatsoever arising from participation or presence at Surfing for Farmers.
I hereby agree that I understand all Surfing For Farmers session around New Zealand at 18yrs+ to take part in. Children are welcome but must be attended to and under the supervision of a responsible adult.
I understand that the farmers and growers are Surfing For Farmers' (the adult) priority and take precedence over children for any coaching, equipment and BBQ and refreshment offerings.
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Full name
Full name
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To enter the Rabobank competition please tick yes to agreeing to their terms.
To enter the Rabobank competition please tick yes to agreeing to their terms.
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