2018 Rodney Coast Challenge Team Entry Form
Sunday 11th November 2018
Check out "The Labyrinth Corporate Team Challenge" - There's $500 Cash up for grabs! 4 PERSON TEAM https://www.rcc.org.nz/details/the-labyrinth-corporate-team-challenge/
Entry Fees - includes event t-shirt*
Team of 2 $ 150 (Youth 13-18 $ 130)
Team of 3 $ 195 (Youth 13-18 $ 150)
Team of 4 $ 220 (Youth 13-18 $180)

*Event t-shirts are included in race packs for entries received before 28th October 2018

Entries with a postal date after 4th November 2018 will be deemed to be late entries. Late entry fee $30.00

No refunds after 4th November 2018 without medical certificate

Entry category *
Team name *
Please use business name if entering The Corporate Team Challenge - e.g. : "Dave's Cafe Team 1"
Your answer
TEAM LEADER First name *
Your answer
Family name *
Your answer
Postal address *
Your answer
Post code
Your answer
Phone *
Your answer
Email *
Your answer
Run Stage First Name *
Your answer
Surname *
Your answer
Email *
Please enter the actual competitors email address, not just the team leaders
Your answer
Road Cycle First Name *
Your answer
Surname *
Your answer
Email *
Please enter the actual competitors email address, not just the team leaders
Your answer
Mountain Bike First Name *
Your answer
Surname *
Your answer
Email *
Please enter the actual competitors email address, not just the team leaders
Your answer
Kayak Stage First Name *
Your answer
Surname *
Your answer
Email *
Please enter the actual competitors email address, not just the team leaders
Your answer
Payment details
Please pay by direct debit to: 12-3139-0048950-01. Please enter team or family name as reference

Entries with a postal date after 4th November 2018 will be deemed to be late entries. Late entry fee $30.00

No refunds after 30th October without medical certificate

Entry Fees - includes event t-shirt
Team of 2 $ 150 (Youth 13-18 $ 130)
Team of 3 $ 195 (Youth 13-18 $ 150)
Team of 4 $ 220 (Youth 13-18 $180)

Entries with a postal date after 4th November 2018 will be deemed to be late entries. Late entry fee $30.00

No refunds after 4th November 2018 without medical certificate

Total Entry fee *
Your answer
Event t-shirts
Event t-shirts are included in race packs for entries received before 28th October 2018. Please indicate sizes required below:
0
1
2
3
4
5
6
7
8
9
XS
S
M
L
XL
XXL
Donation
Direct donation to the Kaukapakapa Scout Group, thanks :-)
Your answer
Total Paid *
Please add up Entry fee and Donation amounts
Your answer
Payment Reference or Cheque Number *
If paying by direct debit please enter the payment reference you used, or if sending a cheque please enter the cheque number. If paying for multiple teams please feel free to email payment details to info@rcc.org.nz
Your answer
Waiver
On behalf of myself and/or fellow team members, I/We accept full responsibility and /or liability for any damage to myself, equipment, fellow team members and/or third parties resultant from my/our participating in the Rodney Coast Challenge event and I/We waiver all or any claims against the race organisers and/or their staff. I/We also acknowledge I/We understand that at no stage are any roads closed to the General Public and I/We must at all times obey road rules in relation to cyclists or pedestrians. I/We also acknowledge that a charge of $30 will be made for any unreturned or lost race bibs and/or transponders
Signed *
Your full name here
Your answer
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