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Last Name: |
First Name: |
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Address: |
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Phone: |
Email: |
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Gender:
(circle) |
Male |
Female |
Age: |
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School |
Own
Bow: (circle) |
Yes |
No |
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Preferred Day
Circle preference |
Tuesday
Thursday
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Term 1 2
3
4 |
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Preferred Group Time
Circle preference |
4–5pm or 4.30–5.30pm
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Archery Experience
Circle most appropriate |
None
Beginner ASA School Camp Other
_______ |
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Health Issues Tutors should be aware of:
_________________________
___________________________________________________________
___________________________________________________________ |
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Declaration:
I agree that my
son/daughter/the named in my care can participate in AimTru Archery (Chch)
Ltd’s Archery coaching programme. I understand that while precautions are
taken, he/she is entering this event at his/her own risk and will not hold
AimTru Archery (Chch) Ltd or it’s staff liable for any loss or injury
incurred at the archery sessions. |
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Signature:
_________________________ |
Date: _______________ |
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Emergency Contact
Name: Print
clearly please |
____________________ |
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Phone:
— home / work /
mobile (circle) |
____________________
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Declaration: I agree
to abide by the rules of AimTru Archery (ChCh) Ltd. |
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Participant’s signature
________________ |
Date: _______________ |
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Return this
form directly to
AimTru Archery (ChCh) Ltd, PO Box 7711,
Christchurch
to confirm
your place
or
email: infochch@AimTru.com
PH: 962 5920
Fax: 962 5921 |
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