City Indoor Netball Registration Form 2017
COMPETITION.
Due to the popularity of social sport teams, teams will be selected on a first in first served basis. Complete the form below to register, once you have been placed into a team you will be emailed instructions on how to complete payment before your registration is complete.

Game Day: Monday Nights (Games played between 5.45-9.15pm)
Venue: Indoor Sports St Lukes, 31 Rossmary Terrace, Morningside
Season: 17 July-Oct

All players will also receive a FREE playing top.

If you would like to enter a full team please email pax.patel@aut.ac.nz for further details.

FEES.
AUT Student/Staff: $100
External: $135

Follow this link to complete payment: http://www.autshop.ac.nz/aut-social-sport/

Full Name *
Your answer
Date of Birth *
MM
/
DD
/
YYYY
Gender *
Are you a current AUT Student? *
If yes, provide your ID number below.
Required
Student ID
Your answer
Email *
Your answer
Mobile *
Your answer
Please choose your shirt size *
Emergency Contact and Medical Information
The following information is required for health and safety reasons.
Emergency Contact Name *
Your answer
Emergency Contact Number *
Your answer
Relationship to you? *
Your answer
Medical Conditions / Allergies *
Do you have any current medical conditions or allergies that could affect your ability to play social sport.
Your answer
AUT SPORT COMMITMENT FORM.
• In signing this form I agree that I will make full payment as above I understand that failure to make full payment by as above may result in my withdrawal from the team by AUT Sport. My place in the team is not secure until full payment is made.

• Withdrawal from competition on, before, or after competition shall not absolve me from paying the full amount of membership.

• Non-payment of monies owed will result in my academic results being withheld until payment is received and may also attract debt recovery
action and associated costs.

• I understand that I represent AUT while attending AUT Sport sanctioned events and at all times when wearing team gear and agree to act in a manner that positively reflects the spirit of AUT. I understand that if I act in a disorderly manner and cause problems for AUT Sport, AUT has the right to remove me from the team.

• I hereby consent to be interviewed, recorded, photographed, videotaped, or filmed by representatives of AUT Sport for the purposes of publication, display or broadcast (print, web, digital display and all other forms of media). I grant AUT the right to edit, use, and reuse said products in print, internet, and all other forms of media, and release AUT, its agents and employees, from all claims, demands, and liabilities whatsoever in connection with the above.

• I hereby defend, indemnify and hold harmless AUT from and against any and all costs, expenses (including legal expenses), losses (including your own personal property), injuries, liabilities, damages, and claims of any kind whatsoever or any damage to property or any other claims, losses, costs or demands arising out of or related to any negligent or intentional act or omission by me.

• AUT will not be liable for any consequential injury or specific damage or loss of any kind whatsoever, nor shall AUT be liable for any damages or loss caused by me whatsoever (whether similar to the foregoing or not).

• I have read and understood all information herein, and have been given an opportunity to seek clarification on the above.

I understand that in signing this form I agree to the terms stated above and commit to participating in the AUT Social team. *
Required
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