Chopper Swim 2019 - kayaker registration
Event Timing: 18 March 2019
Event Address: Waiheke Island
Contact us by email at olaf@chopperswim.nz
First Name *
Your answer
Last Name *
Your answer
Phone Number *
Your answer
Email *
Your answer
Next of Kin name *
Your answer
Next of Kin - Relationship to me *
Your answer
Next of kin - Phone number (please include area codes) *
Your answer
I confirm that I am suitably qualified and physically capable of completing the event *
Required
I have read and understand the Participant's Information Sheet (see https://www.chopperswim.nz/registration) *
I have read and understand the Acknowledgement Form (see https://www.chopperswim.nz/registration)
Please list any known health conditions that may be relevant *
Your answer
Swimmer or team I am supporting. Enter TBD if a swimmer/team will be allocated to you by the organisers *
Your answer
My kayak is *
Kayak material *
Any distinguishing features of your kayak
Your answer
I can provide a VHF radio
I intend to transport my kayak to Waiheke by *
I confirm that I will carry the required safety equipment i.e. life vest, signal whistle (and a flotation device if supporting a solo swimmer) *
I understand and accept the risks inherent in my participation in the 2019 Westpac Chopper Swim and accept that the primary responsibility rests with me. *
Any further comments or questions
Your answer
I CONFIRM THAT I WILL ADVISE EVENTS ORGANISORS OF ANY CHANGES TO THE ABOVE VIA EMAIL to olaf@chopperswim.nz *
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