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PRESIDENT†††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††† †††† †††††† †SECRETARY

Rik Simpson††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††† †††† †††††††††††††††††† ††Sarah Clinch

6 Tainui Road†††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††† †††† †††††††††††††††††† ††96 Barrack Road

Howick†††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††† †††† †††††††††††††††††† ††Mt Wellington

Auckland†††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††† ††††††† ††††††††††††††††††††††††††††††††††††††† ††Auckland

Ph:†† (09) 535 6120†††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††† ††††††† ††††††††††††††††††††††††††††††††††††††† ††Ph/Fax:† (09) 570 5989

Fax: (09) 576 3661††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††† †††††† †††††††††††††††††††††††††††††††††††††††† ††e-mail: nervana@xtra.co.nz

e-mail chiro180@ww.co.nz†††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††

†††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††

Membership Registration Form†††††††††††††††††††††††† http://eastcitybmxnz.tripod.com

Welcome to East City BMX Club

Registration Fees Full Licence for 20Ē & Cruiser:

1 rider per family ††††††††††††††††††† $85

2 riders per family†††††††††††††††††† $170

Additional riders per family††††† $70 each

Registration Fees Novice Licence

1 rider per family†††††††††††††††††††† $50

2 riders per family†††††††††††††††††† $100

Additional riders per family††††† $35

New members MUST show a copy of their Birth Certificate. Make cheques payable to East City BMX Club.

Registration Form for 2002/2003

Parents/Guardians Names __________________________________________________________

Address _______________________________________________________________________

Phone ______________________________† Fax _______________________________________

Mobile No. ___________________________ E-mail _____________________________________

Riderís name/s†† †††††††††††††††††††††††††††††††††††††††††††††††††Date of Birth†††††††††††† Bike No.††††††††††† Licence No.

       
       
       
       

Parent/Guardian supervision is required for all children at club nights.†††††† Total Fee enclosed: $ ___________

Disclaimer: East City BMX Club will take no responsibility for personal injury, damage to property or theft of bicycles or property incurred while at the Merton Road Reserve. Parents will be liable for any damage caused by their children to the premises on Merton Road Reserve.

Signed by Parent/Guardian __________________________________________

Parentís Information: Can you please help the Club with your skills?

Parentís Occupation:________________________________________________________________

Can you help with any of the following?† (1)† BBQ roster_____†††† (2)† Lawn mowing roster_____

(3)† Working bees_____††††††††††† (4)† Help on Club nights_____†††† (5)† Committee member _____

(6)† Other_____

Do you use and check Email regularly?† Daily____†† Weekly____†† Occasionally____† Never____

Please return registration forms to the Treasurer: Sue Simpson, 6 Tainui Road Howick††

†††††††††††

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