Motu Challenge - Opotiki's Motu Challenge, One of New Zealand's Premier Multisport races, is a Road Cycling, Mountain Biking, Kayaking, Running and Endurance Adventure Race Motu Challenge - Opotiki's Motu Challenge, One of New Zealand's Premier Multisport races, is a Road Cycling, Mountain Biking, Kayaking, Running and Endurance Adventure Race

Sat 13 October 2012

Motu 160 Entry Form - 2012

Please complete and submit the online form and post your entry fee payment (cheque)  to the address below. Alternatively you can print this entry form - (Please wait for updated 09 version) (Acrobat Reader Required), and post, complete with the entry fee to:

Multisport Opotiki Inc.
19 Elliott St
Opotiki 3122
New Zealand

Paying electronically?

Please be sure to use the reference: {Your Name},

To help with volunteer administration please pay electronically at the same time as you submit your entry form.

Use the following details:
Multisport Opotiki
ANZ Opotiki
01-0387-0002317-00

Thanks for entering. 

If you have questions regarding the entry form please contact Multisport Opotiki on:

  • Ph: 64 7 315 3031
  • Fax: 64 7 315 3032 Att: Tina
  • Race Info: Rosalie Teddy A/H (07) 3157280
  • 07 315 3031 Opotiki i-SITE
  • Email: info@motuchallenge.co.nz
     

Except for the team events, entries are restricted to persons aged 16 years or over on the day of the event. Competitors under the age of 16 must have the signed consent of a parent or guardian. Entries close at 3pm, 30th September and there are no refunds after this date. Late entries incur a $20 fee.

Note: HIGH SCHOOL TEAMS must be made up of students from the school entered and must still be students of that School on the day of the race. All Veterans (individuals and team members) must be 40+ on race day.

PLEASE ENTER AGES AS ON DAY OF RACE

Please input your contact details:
Your Name:  *
Your Email:  *

Category - Please select a category
Individual:


2 Person Team:


Contact Details - Individual or team representative
First Name:
Surname:
Age:
Sex:
Address:
Suburb:
Town or City:
Country:
Post Code:
Phone:
Email:
Sponsor:
Team Details - Please enter name and details of competitor in each stage
Team Name/Sponsor:
Mountain Bike:   Age:     
Cycle:   Age:     
Entry Fees
   $80
  $140
  $20
Men's Motu 160 Tee-Shirt
$30 each
S:
M:
L:
XL:
XXL:
Women's Motu 160 Tee-Shirt
Size / ½ Chest (cm) Quantity
8 / 41
10 / 43.5:
12 / 46:
14 / 48.5:
16 / 51:
How would you like to pay
Pay By:    
  
  

Team Representative's Declaration

In return for Multisport Opotiki Inc permitting us to participate in The Motu 160 Challenge we agree that:

1. That we have read and understood the Rules of the Challenge, and agree to be bound by them including any modifications subsequently advised prior to the race or contained in the race pack(s).

2. That participating in the Challenge might cause serious injury, damage to property, cause trauma to friends and family spectating.

3. That we participate in the Challenge entirely at our own risk.

4. That we will not make any claim against organisers, sponsors or its agents for any injury in connection with our participating in the Challenge, regardless of how the injury, damage, or loss or expense occurs whether through negligence of organisers, sponsors or their agents.

5. That we shall advise the organisers of any existing medical condition that may affect us and consent to receiving any medical attention which organisers or its officials deem necessary in the circumstances.

6. That any photos and videos taken of us together with our names may be used by Multisport Opotiki Inc and its sponsors for promotional purposes.

7. That we indemnify event organisers, sponsors and their agents against all claims, damages, losses or expenses which they may incur as the direct or indirect result of any injury, damage to any property, trauma to friends and family.

8. That we are aware of and understand the Challenge rules in relation to late entries and no refunds.

9. We acknowledge that the Challenge judges decision shall be final.

10. I am the authorised agent of any member of my team.

I agree to the above conditions on behalf of myself and all team members.

Team Representative's Signature
Signature:
* Type your name in this field before Submitting to indicate that you understand and accept our terms and conditions.
Date: