NZJSA Driver Membership Form

NZJSA Driver Membership
Membership Type: *

Driver - $700
Name: *

First Name Last Name
Birth Date: *

Day Month Year
Address: *

Street Address

Suburb

City

Postcode Country
E-mail: *
example@example.com
Phone Number: *

Area Code Phone Number
Emergency Contact
Name: *

First Name Last Name
Phone Number: *

Area Code Phone Number
Team Profile
Class: *
Boat Number:
Boat Name:
Navigator Name:
Occupation:
Engine Specifications & HP:
Hull Type & Jet Unit:
Sponsors:
Upload NZPBF Medical and UIM Anti-doping Form

Only fill in the UIM TUE (Therapeutic Use Exemptions) form if you are taking a medication on the Prohibited List.
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Privacy Statement:
We collect your personal information in order to maintain a NZPBF licence register. Besides the NZJSA Secretary, this information is shared with the NZPBF in order to issue licences. If you choose not to enter the required details, we will not be able to accept your membership registration. You have the right to ask for a copy of any personal information we hold about you, and to ask for it to be corrected if you think it is wrong. If you'd like to ask for a copy of your information, or to have it corrected, please contact the NZJSA Secretary at nzjetsprint@gmail.com.
Membership Declaration: *

I have read, understand and agree to abide by the New Zealand Jetsprint Association rules and constitution.
Once you submit your application, an invoice will be emailed to you with payment instructions to complete your membership registration.

Thank you!
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NZJSA Driver Membership

Emergency Contact

Team Profile

Privacy Statement: