Support Crew Submissions

Support Crew Registration

Support Crew registrations for the 2012 Charity Bike Ride opened on Sept 1st 2011 and will close on Nov 31st 2011. Ride numbers are limited so don't leave your registration too long!
The online form below is for Support Crew Only - Rider registrations can be found here

Please Note: Your entry will not be confirmed until your registration fee has been received.
Once you have made payment you can check your registration status here. Please allow a few days from the time of payment for your name to appear on the list. If you have made payment and your name hasn't appeared after 5 days please contact Chris by email here

Online Registration
Entries by Online Registration can be made by completing the form below.
Once the form has been submitted you will receive an email with your registration details and payment instructions.
To check your submission was successful you can check this page which updates every time a form is submitted

Postal Entries
To submit a postal entry please go here

Online Registration Form (Support Crew Only)

By submitting the form below you agree that:
You have read and understood the "Conditions of Entry" on THIS PAGE (Click to view)
Last Name(*)

Last Name required!
First Name(*)

First Name required!
Address(*)

Address required!
Date of Birth(*)

Date of Birth required!

(eg. 12/09/1965)
Gender(*)

Gender is required!
Email Address(*)

Invalid email address!
Confirm Email(*)

Invalid email address!
Phone No.(*)

Phone number required!
Mobile No.(*)

Phone number required!
Emergency Contact Name(*)

Contacts name?
Emergency Contact Phone(*)

Contact's number?
Support Type - $110(*)

Ride group required!
Current Drivers License?(*)

Ride group required!
Confident with a trailer?(*)

Ride group required!
Shirt Size(*)

Shirt is required!
Existing Conditions(*)

Any medical condition!
(Medical conditions for which you are being treated) Asthma, Heart condition etc.
Detailed Medical Information

Invalid Input
(If you answered yes to the above please supply details here. All information will be treated with the utmost discretion)
Payment Method(*)

Payment method!
Additional Meal Tickets(*)

Additional meals?

(Extra Meal tickets for Saturday night's dinner can be purchased for $35ea)
Kurow Accommodation(*)

Accommodation?
WAIVER RELEASE & INDEMNIFICATION
In consideration of my entry in the 2012 Central South Island Charity Bike Ride, I have read and hereby agree to the Rules and Conditions of Entry. I hereby release, exempt and indemnify the organizers, sponsors and other persons and organizations involved from all action, proceeding, demands and costs, expenses and claims whatsoever made or taken by any person arising out of my participation in the 2012 Central South Island Charity Bike Ride.
U18:
Persons under the age of 18 cannot submit this online form.
A parent or guardian is required sign an entry for anyone under the age of 18.
Please complete a Postal Form from the Registration Menu above if you are under 18.
Drivers:
Must have had a current full drivers license for at least 2 years
I agree with Waiver(*)

Acceptance is required!
Please help us to target our advertising by letting us know how you found out about the Charity Bike Ride.
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