Request edit access
2019 Massey University Tertiary Nationals Registration
This form is for Massey University Staff to create a pool of interested students, from which teams will be selected to represent Massey University at their respective sport's Tertiary National Championships. Please fill out the form below, or contact Sport Coordinator, Chris Sharrock, at C.Sharrock@massey.ac.nz, if you have any questions.
First Name: *
Your answer
Last name: *
Your answer
Gender *
Date of Birth: *
MM
/
DD
/
YYYY
Ethnicity *
Your answer
Student ID number: *
Your answer
Email Address: *
Your answer
Best Daytime Contact Phone Number: *
Your answer
Emergency Contact Name *
Your answer
Emergency Contact Number *
Your answer
Do you have any medical conditions or allergies we need to be aware of? If yes, please list. *
Your answer
Which Campus are you Currently Studying at? *
Are you Studying Full-time or Part-time? *
Year of Study *
Course of Study *
Your answer
Sport(s) of Choice: *
Required
What Position do you normally play (if applicable)? *
Your answer
Level of Experience/Notable Achievements/Teams you have been a part of: *
Your answer
Are you a current member of a Massey University Club? *
If yes, what club(s) are you a part of?
Your answer
Do you agree to be contacted by Massey University with further information about the sporting events for the sports you have selected above? *
Do you agree to your information being passed on to the coach/manager of the team in question and for them to inform you of a trial date? *
Are you available for the dates of the sporting events selected above? *
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service