Rogaine and Dogaine Entry Form

Category
Dog
Duration

Team Members

Team Captain
Team Member 2
Team Member 3
Team Member 4
Emergency Contact / Pre-existing Medical Conditions

Payment

Entry Fees (includes single lift pass on the Gondola for 2 hr category, and multi lift pass for 4 hr category:

Adults - $60 (4 hour), $30 (2 hour) 

Student discount $10 off adult price for 4hr, or $5 adult price off for 2hr, with student ID

Children (6-15) - $30 (4 hour), $15 (2 hour) 

Children (5 and under) Free

Account Name: Chris Forne, Account Number: 06-0665-0150257-00. Use as Reference - Team Name, Particulars - Dogaine, Code - Surname

PRE-ENTRY is required BEFORE 8pm Friday 15th March.

Please pay by bank transfer. We may accept entries on the day, subject to numbers, but these will incur an extra late payment fee. This makes our organisational job much easier, so we would really appreciate your cooperation. Thanks (-:

Indemnity

We hereby acknowledge that the New Zealand Rogaining Association, the Event Organisers, and the owners of the land used for this event, accept no liability for any loss, damage or injury to ourselves (including vehicles at the event venue) resulting from our participation in this event. We enter this event at our own risk and acknowledge that there may be risks associated with the sport of Rogaining. We understand the safety requirements set out by the organisers and agree to abide by the New Zealand Rogaining Association Code of Conduct as on the website www.rogaine.org.nz. Please note: Team captain must ensure this indemnity has been read and understood by all team members.

Note: A parent or guardian must sign the indemnity form on behalf of a competitor under the age of 18.