Port Hills Athletic Club Inc

PORT HILLS ATHLETIC CLUB INC.

Children’s Summer Subscriptions for year 1ST April 2016 to 31ST March 2017

NOTE: This subscription form is for children aged 14 and under as at 31st December 2016

Family Name:
Child 1 First Name: / Male/Female: / Date of Birth:
Child 2 First Name: / Male/Female: / Date of Birth:
Child 3 First Name: / Male/Female: / Date of Birth:
Address:
Phone Number: / Mobile:
Email:
Adult(s) responsible for Child(ren):

NOTE: Age for fee is calculated as age as at 31st December 2016

Membership Type** (select either A,B or E) / Child 1 / Child 2 / Child 3
A) Athlete is already member (winter member) / $20 / $20 / $20
B) Athlete summer track and field registration / $83 / $83 / $83
C) Optional: Training Coaching (ages 7 - 11) / $30 / $30 / Free
D) Optional: Training & Coaching (ages 12 - 14) / $50 / $50 / Free
E) Athlete is Under 7 / $55 / $55 / $55
Grand/Sub Total All Children: (Please fill in) / $

**See the notes on reverse for an explanation of above table

Saturday Interclub - Canterbury Children’s Athletic Association (CCAA)

Note: There are no refunds so do not register your children for Saturday interclub until you are sure this is what they want to do. All athletes get 2 weeks free at any time during the season up until registration close off in February – use these 2 weeks to make your decision. To compete in Saturday interclub, there is a website link available from the Port Hills Track and Field Web Page which provides a link for registering.

IMPORTANT NOTICE TO PARENTS/ CAREGIVERS
To ensure that Club Events run effectively assistance from parents/caregivers is essential. Parents/caregivers will not be asked to coach, but rather to help in set up, supervision, time keeping, etc.

DECLARATION FORM 2016/2017 SEASON

To meet our responsibilities under the Privacy Act we ask you to indicate your agreement to your details being made available to Athletics New Zealand and other organisations associated with athletics.

Signature of Parent/Caregiver: / Date:

Return form with direct credit to account 03 1593 0019376 00 (tick box) or cheque payable to Port Hills Athletic Club for the appropriate fees to the mailbox in the Hansen Park clubrooms or mail to Port Hills Athletic Club, PO Box 12-069 Beckenham, Christchurch 8242. No responsibility taken for cash. Do not mail cash. If you pay by direct credit you may email the completed form to

Fees Direct Credited: / Important: If paying by direct credit, enter your full name in the reference field.

Notes about the 2016/2017 children’s subscriptions

If you have any queries relating to this form, please contact Megan Allan or email

1. WHERE DOES YOUR SUBSCRIPTION GO? Your subscription goes towards providing Club events, the facilities, including the clubrooms, the Club Newsletter and Club Website www.porthills.org.nz. A portion is paid to Athletics NZ (NZAA) and Athletics Canterbury (CAA). This helps sustain our sport in NZ, and provides all Club Members with Public Liability insurance when taking part in Club and other official athletic events. Apart from our fund raising activities your subscriptions are what keep your Club operating.

Category / Total / Club Sub / NZAA and CAA / Track and Field Resource Fee / Optional: Training Fee
Age 7 to 11 - already a member (winter member) / $20 or $50 / $20 / $30
Age 7 to 11 - summer track and field registration / $83 or $113 / $30 / $33 / $20 / $30
Age 12 to 14 - already a member (winter member) / $20 or $70 / $20 / $50
Age 12 to 14 - summer track and field registration / $83 or $133 / $30 / $33 / $20 / $50
Under 7 / $55 / $30 / $5 / $20

2. Athlete is already member (winter member) is those who have already joined the club as either registered or club events only for the winter season. Children who are already registered as winter athletes have already paid the Club Sub and NZAA/CAA portion, resulting in the lower cost.

3. Athlete will compete in Saturday Inter-Club is for those who wish to take part in events organized by Canterbury Children’s Athletics Association. This is a weekly event that is organised to include all clubs and includes the Canterbury Championships events and events which cater for all abilities.

4. All members please fill in ALL relevant details (Athletics Canterbury & NZ want these for all members and allow plenty of time (preferably one week) for registrations to be processed.

Welcome to Port Hills Athletic Club Inc. If you have any ideas, queries or complaints please do not hesitate to talk to a committee member.