To be eligible to be considered for selection this form must be completed and submitted unless alternative arrangements have been agreed with the HP Director or HPAD Lead, as applicable.

Question Title

* 1. Rider Details

Question Title

* 2. Rider Details - Passport

Question Title

* 3. Rider Details - Passport 

Question Title

* 4. Next of Kin

Question Title

* 5. Coach

Question Title

* 6. Event/s you wish to be considered for

Question Title

* 7. Teams: If I am eligible, I wish to be considered for selection to any Team(s) that Cycling New Zealand selects to attend the international competitions for my discipline listed in the Cycling New Zealand Selection Regulations.

Question Title

* 8. I have been provided with access to a copy of the Cycling New Zealand Selection Regulations 2021-2024 either directly or via the Cycling New Zealand website.  I agree to comply with and be bound by the terms of that Regulation.

Selection Regulations

I acknowledge that any right of appeal and the process for such an appeal in relation to my non-selection must be exercised in accordance with the Cycling New Zealand Selection Regulations.

I acknowledge that it is a condition of my application for selection that I must complete, sign, and return by the due date to Cycling New Zealand, an Athlete Agreement.

I have met, or will by the Selection Date have met, the eligibility requirements specified in clause 4 (Eligibility) of the Cycling New Zealand Selection Regulations.

I will notify Cycling New Zealand of any changes to my contact details.  I accept that any failure by me to do so may be to my detriment as any announcement regarding selection of a Team will be notified to me personally or to at least one of the contact addresses provided.

I agree Cycling New Zealand may collect personal information about me for the purposes of consideration and selection.

I may obtain independent advice on the terms of this application form and its implications, and I have been given a reasonable opportunity to do so.

I have read and understood the ‘International Event Entry’ process (found on https://www.cyclingnewzealand.nz/covid-19/), I am aware of the requirements, and I agree that if selected, my selection is conditional on this application being completed by myself and accepted by Cycling New Zealand.

When the Cycling New Zealand General Risk Assessment for the event/s I have selected is available, I will read, understand and accept any associated risk of attending the events.

* If the rider is under the age of 18 years as at the date of completing this form, the form must also be completed by the parent(s)/guardian(s) of the rider in the space provided below.

T