Canterbury Car Club Volunteer Engagement Form 2024/25 Season

Name*

First NameLast Name

Preferred Name

Postal Address*

Street Address

Street Address Line 2

City

Post Code

Phone Number*

Phone Number

Email

example@example.com

Date of birth*

Gender*

FemaleMaleOther

Emergency Contact*

Full NamePh Number

Events Types you currently help at:*

RaceMotorkhana/AutocrossSprints

Department*

Do you hold a current first aid certificate

YesNo

Do you hold a current car drivers licence?

FullRestrictedLearners

Do you have any conditions which may affect your ability to effectively carry out your role? If yes please give details.

Volunteers who commit to helping within the season will be gifted complimentary membership to the Canterbury Car Club. Memberships will be issued at the discretion of the CCC General Manager.

Your information will not be shared with anyone else.

Membership Declaration:
I declare that this information supplied by me is true and correct and I consent to the collection, retention, use and disclosure of it by the Canterbury Car Club Inc. for the lawful activities of the Club.

I agree to meet my obligations under the Health and Safety at Work Act 2015.
I agree to abide by and be bound by the Constitution, By-laws, Rules and Policy of the Canterbury Car Club Inc.

I do not have any convictions or legal restrictions which would prevent me from carring out my duties.

My consent is given in accordance with the Privacy Act 2020.

The Canterbury Car Club Inc reserve the right to request a police check or drug/alcohol test in accordance with any NZ laws.

Volunteer's Rights & Responsibilities

Media, Health & Safety, and Drug & Alcohol Policies

Motorsport NZ Volunteer Handbook

Check this box to agree with the above declaration