CTC | 2025 Development Programme form

2025 Development Programme
Rider's Details
Rider's Full Name*

First NameLast Name
Rider's Email*
example@example.com
Rider's Phone*
Date of Birth*

DayMonthYear
Date
Gender

MaleFemaleNon-Binary
Rider's School
Other Sports
Medical issues we should be aware of
Rider's Address*

Number & Street

Suburb

CityState / Province

Postal / Zip Code
Emergency Contact Name*
Emergency Contact Phone*
Caregiver Details (if under 18 years of age)
Caregiver Name

First NameLast Name
Caregiver Email
example@example.com
Caregiver Phone Number
Please enter a valid phone number.

Fees and Payment
Fees/Payment
$150.00 per rider. This includes the use of a Club track bike for the season, track levy, participation in the Development Programme and ongoing tuition during the track racing season.

Bring your own helmet, cycling gloves, shoes, and clip-in pedals (if using). Bikes will have flat pedals if you do not use clip-in pedals.

Direct payment to ASB 12-3147-0354579-00. Please use surname as Reference.
Payment is due on registration and by 9 November at the latest.

EftPos/Paywave available at the registration desk.

Disclaimers and Agreement
RULES ON USE OF DEVELOPMENT BIKE
1. Priority will be given to first-year Development riders.
2. Riders are not to change any equipment on the bike issued.
3. Bikes are for use at CTC race sessions and are not to leave the Denton Park Track area unless prior permission has been received from the Committee.
4. If there is an opportunity to race in other areas of New Zealand, Development bikes may be used. A Bond payment of $50.00 is required before the event and will only be refunded if the bike is returned in the same condition as when bonded out. Any damage done whilst out is to be covered by the user.
5. After each day of training/racing, it is the user’s responsibility to return the bike to the lock-up rooms. DO NOT LEAVE OUTSIDE.
Disclaimers: Canterbury Track Cycling and any volunteers assisting at any race meeting will take no responsibility for personal injury incurred during any race meeting and at any other time relating to track racing. We are required to make this disclaimer under the terms of the new ACC Act.

All riders and club members agree to abide by the Cycling NZ Code of Conduct, located on the Cycling NZ website:

https://www.cyclingnewzealand.nz/about-us/organisation-documents/ Policies and Guidelines/Cycling New Zealand Code of Conduct

Please sign below to show that you have read and understood the disclaimers. Under 18? Please have your caregiver sign and date the form.
Rider's Signature*

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Rider's Agreement Date*

DayMonthYear
Date
Parent Signature (if rider under 18)

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Parent Authorisation Date

DayMonthYear
Date
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2025 Development Programme

Rider's Details

Caregiver Details (if under 18 years of age)

Fees and Payment

Disclaimers and Agreement