Queenstown Alpine Ski Team
2018 Queenstown Alpine Ski Team Registration Form
Email address *
Athletes Name *
Your answer
Date of Birth (example 01/12/00) *
DD/MM/YY
Your answer
Gender *
Nationality *
Your answer
School Attending 2018 *
Year at School 2018 *
Parent/Guardian 1 Name *
Your answer
Parent/Guardian 1 Phone contact *
Mobile no Home no Email address
Your answer
Parent/Guardian 2 Name
Your answer
Parent/Guardian 2 Phone contact
Mobile no Home no Email address
Your answer
Emergency Contact name (Cannot be Parent or Guardian)
Your answer
Emergency Contact No (Cannot be Parent or Guardian) *
Mobile no Home no
Your answer
Athlete Residential Address *
Your answer
Age Group and Programme (Deposit is non refundable) *
Speed Camp U14/U16 *
School Skiing for Year 8 and below excluding Junior Academy *
Injury Insurance *
Payment Options. Non refundable deposit to be paid on the 15th March 2018, Instalment dates 1st June 2018 and 27th July 2018. *
If QAST invoices are not paid 10 working days after invoice due date, interest will accrue at 2% per month and credit cards will automatically be charged on the 10th day. Any issues with processing credit card payments will result in the athlete being withdrawn from training until full payment is received. All QAST athletes are required to submit valid credit card details to ensure invoice payments are duly paid.
Credit Card Details (Visa or Mastercard only). *
Name on card
Your answer
Card Number *
Your answer
Expiry Date (card must be valid for at least 12 months) *
Month/Year (example 01/19)
Your answer
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