GRUBS registration and event entry form

GRUBS registration and event entry form
GRUBS - GRommet Umina BoardriderS Incorporated - is the Junior Division of Umina Boardriders and is open to both male and female junior surfers.

GRUBS is held on the 1st Sunday of each Month, February to December, on Umina Beach

There are two Divisions in GRUBS. Members may participate in either or both Divisions

Competition Heats - Competition format with timed heats, judges scoring and progressive pointscore.

Free Surf- If time allows, to surf as a group with no timed heats, judging or pointscore.

In Accordance with GRUBS Surfing NSW Insurance and Affiliation and Central Coast Council Event Approval, all GRUBS Members MUST be registered with registration fees paid in full to participate in any GRUBS Event.

Participants in GRUBS will need their own board and wetsuit. If you need to borrow gear we have a limited amount - just ask!
Name of person completing form

First NameLast Name
Email
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
First competitor full name

First NameLast Name
Date of Birth

DayMonthYear
Gender
Different identity (please describe)
Division
Nationality
Are you Aboriginal or Torres Strait Islander origin?
Second competitor full name (if applicable)

First NameLast Name
Date of Birth

DayMonthYear
Gender
Different identity (please describe)
Division
Nationality
Are you of Aboriginal or Torres Strait Islander origin?
Third competitor full name (if applicable)

First NameLast Name
Date of Birth

DayMonthYear
Gender
Different identity (please describe)
Division
Nationality
Are you of Aboriginal or Torres Strait Islander origin?
Membership type (select all that apply)
Membership payment options:

Direct deposit:

Grubs-Grommet Umina Boardriders Inc

BSB: 633-000

Account Number: 156632010

Pls put each full membership name/s as reference.

Tshirt Size for competitors (select all that apply)

Rows	6 - XS	8 - S	10 - M	12 - L	14 - XL	16 - XXL
Youth (1st competitor)
Youth (2nd competitor)
Youth (3rd competitor)
Youth (non competitor)
Youth (non competitor)

Event Entry Application and Declaration
Please read these SNSW Individual Member Terms and Conditions

Click Here
I have read the T&Cs linked above and agree to the BRC and Surfing NSW T&Cs
Right to Use Image: I acknowledge and consent to photographs and electronic images (including, but not limited to, moving images) being taken of me during my participation in the Event/Competition. I acknowledge and agree that such photographs and electronic images are owned by Event Organiser/GRUBS Grommet Umina Boardriders and it may use the photographs and electronic images for promotional or other purposes without my further consent being necessary. Further, I consent to Event Organiser/GRUBS Grommet Umina Boardriders using my name, image, likeness and also my performance in the Event/Competition, at any time, by any form of media, to promote Event Organiser/GRUBS Grommet Umina Boardriders
Date* First Name* Last Name*

Payment details - transfer via bank transfer below:

$120 first competitor

$80 second competitor

$50 third competitor or non competitive member

Account name:

Grommet Umina Boardriders Inc

BSB: 633-000

Account No: 156632010

pls put the full name of each member as reference.
Should be Empty:

GRUBS registration and event entry form

Event Entry Application and Declaration