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TOA FEILDING, RANGITĪKEI / OROUA - ADULT REGISTRATION
This Registration form is only a registration of interest. All applicants will be contacted before 1st of September with next steps.
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* Indicates required question
INGOA (Name)
*
Your answer
Date of Birth
*
Your answer
Address
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Your answer
Email
*
Your answer
Phone Number
*
Your answer
Whanau support INGOA and Email
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Your answer
Iwi /Hapu
*
Your answer
Te Reo
some
well
very well
none
Clear selection
Nga TOA moemoea/ hopes/ aspirations?
*
Your answer
Connection to Marae in the last 12 months (if so which?)
Your answer
Do you take and medicines (if so which)?
Your answer
Are there any health conditions you would like to address?
Your answer
Can we korero with your GP? (if so who)?
*
Your answer
What size T-Shirt are you?
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S
M
L
XL
XXL
XXXL
I consent to having my photo/video images taken by TOA staff to be used in printing and digital promotion material for TOA.
*
Yes
Required
By ticking the YES box below i understand that i am registering my interest to be a participant for TOA Feilding, Rangitikei / Oroua.
*
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Required
Date
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