This form is an Expression of Interest for officials to take part in the Trampoline World Championships on 7-9 November 2014, Daytona Beach, USA. Please read and complete each question carefully, making sure all information is accurate. Thank you

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* 1. Position on Tour

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* 2. FULL LEGAL NAME - This must be the name that appears on the athletes passport

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* 3. Preferred Name - If different from above

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* 4. Physical Address

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* 5. Email Address

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* 6. Mobile Phone Number

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* 7. Home Phone Number - Please include area code

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* 8. Work Phone Numer - Please include area code

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* 9. NZ Passport Number

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* 10. NZ Passport Expiry Date

Date

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* 11. Club Name

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* 12. Previous tour experiences

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* 13. Consent - By ticking this box you are agreeing to GymSports New Zealand Terms and Conditions.

Please see the overseas Tour Policy for further information.

If you have any further questions, please contact Katie Dee on overseas.tours@gymsportsnz.com

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* 14. Today's Date

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