U19 Nomination Form

Nominations for the U19 team have now closed. If you are filling in this nomination form and have not been in touch with Annika Wing prior to doing so, please email her at annika@rowingnz.kiwi

Question Title

* 1. Athlete details

Name

Gender

Date of birth

Address

City/Town

ZIP/Postal Code

Email Address

Phone Number

Question Title

* 2. Rower headshot

Please upload a current headshot (make sure the file is named with your name)

PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only.

Choose File

Question Title

* 3. Current club and school/university your are representing

Question Title

* 4. Passport details

Name

Expiry date

Passport number

Question Title

* 5. Coach details

Name

Email Address

Phone Number

Question Title

* 6. Anthropometry

Height (cm)

Weight (kg)

Arm span (cm)

Question Title

* 7. Do you scull?

Yes

Question Title

* 8. Do you row bow?

Yes

Question Title

* 9. Do you row stroke?

Yes

Question Title

* 10. Which is your preference

Scull

Row bow

Row stroke

Question Title

* 11. 2km PB

Best 2km erg time (mm.ss.00)

Best 2km erg average split

Date this erg test was completed

Witness by

Question Title

* 12. 5km test or 30min @ 20 erg (completed between 11 Oct-15 Nov 2021)

5km/30min erg time (mm.ss.00)

5km/30min erg average split

5km/30min erg average rate

Date this erg test was completed

Witness by

Question Title

* 13. I confirm that all information provided in this nomination form is true and correct at the time of completion

Yes