Tri Pounamu - Event Request Survey

Event Survey

Thank you for completing this short survey. Upon return of this survey, we will be in contact to deliver your event support.
The data collected allows us to provide information to third parties to register you for events. Some identifying information will be passed on to third parties including for the purposes of entering you into events.

Question Title

* 1. What is your full name? (as you would like it to be on entries)

Question Title

* 2. Date of Birth

Question Title

* 3. What are your email and mobile contact details to arrange delivery of your event support?

Question Title

* 4. What event are you requesting support for?

5km series (Jan/Feb)

XRace (March)

City2surf (March)

Victoria Park Hikoi

Swim Coaching

Rapaki Pick Up

Waikawa Marae Hikoi including St Clair Half Marathon (May 12th - 15th)

Otautahi CBD Tour o Te Taone

Nga Arapiki

Squad Training for Events

Something else

Any other events?

Question Title

* 5. Do you have a medical condition that would affect your ability to exercise?

Further comments

Question Title

* 6. Consent to register for an event

I am under 18 have parental consent

I am under 18 and don't have parental consent

I am over 18 and give consent

I am over 18 and don't give consent

I need more information before I give consent

Comments - Please note if we do not have consent we are unable to process your entries. If you ticked no to consent or need more information please ensure you have given us contact details so we can follow up with you an answer any questions you have. If you are under 18, please provide your parent or guardian's name and phone number below.

Question Title

* 7. Have you done an exercise event before?

Yes - in the last month

Yes - in the last six months

Yes - more than a year ago

Further comments

Question Title

* 8. Can you currently do any of the following? Answer as many as applicable

Swim any stroke for 200 metres (8 lengths of the council pools) in one go

Bike at least 10 kilometres (not a stationary bike) in one go

Walk at least 5 kilometres in one go

Hybrid (mixture of running and walking) at least 5 kilometres in one go

Run at least 5 kilometres in one go

No - none of these

Further comments

Question Title

* 9. How many days a week do you currently exercise for 30 minutes or more?

Question Title

* 10. What is your current health and wellness goal for 2017?

Question Title

* 11. Are you interested in doing any other events in 2017?

Yes

Do you have any events in mind?

Question Title

* 1. What is your full name? (as you would like it to be on entries)

Question Title

* 2. Date of Birth

Question Title

* 3. What are your email and mobile contact details to arrange delivery of your event support?

Question Title

* 4. What event are you requesting support for?

Question Title

* 5. Do you have a medical condition that would affect your ability to exercise?

Question Title

* 6. Consent to register for an event

Question Title

* 7. Have you done an exercise event before?

Question Title

* 8. Can you currently do any of the following? Answer as many as applicable

Question Title

* 9. How many days a week do you currently exercise for 30 minutes or more?

Question Title

* 10. What is your current health and wellness goal for 2017?

Question Title

* 11. Are you interested in doing any other events in 2017?

Question Title

* 12. Do you have any further comments or questions?