Registration Form - Rural Women NZ
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THE TRIPLE F CHALLENGE 2020
“FUN, FITNESS & FRIENDSHIP”
24TH 25TH & 26TH APRIL 2020
EXPERIENCING CROMWELL AND SURROUNDINGS
By sight sound & taste
and a good pair of walking shoes
Registration Form
Please read and complete all 5 pages per person
Please sign and date and return by 13th December 2019
Please return completed form to our registration officer Pat Macaulay
12 Holborn Avenue, Mosgiel 9024 pat.macaulay@outlook.com
Registration details
NAME……………………………………….……EMAIL…………………………………………………..
ADDRESS………………………………………………………………………………………………………
CONTACT NUMBER………………………………………………………………………………………
RWNZ MEMBER: YES/NO
BRANCH NAME…………………………………………………………………………………………….
OR INDIVIDUAL MEMBER …………………… (PLEASE TICK IF YES)
EMERCENCY CONTACT NAME & PHONE NUMBER……………………………………….
RELATIONSHIP to Participant e.g. Father, Husband etc………………………………..
Funds raised during the Triple F Challenge 2020 will be donated to:-
•K9MD
• Judge Emma Parson chosen charity,
Community Advisory Group (CAG)
• Judge Emma Smith chosen charity, to be advised
All personal information requested is required for the purposes of supporting the
health and safety of all participants. All information held will be stored securely and
in accordance with the provisions of the Privacy ActTriple F Challenge 2020 Programme
DAY ONE 24TH APRIL 2020
09.30am – 10.15am Welcome Lowburn Hall – Lowburn Valley Road, Lowburn
10.30am - 2.30pm Guided tour Cromwell Goldfields Guide – Terry Davis
3pm – 4.30pm Afternoon Tea
6pm - Dinner – The Gate 6 Barry Ave. Cromwell 9310
Christinz Clothing will be on display. To try and buy.
Dinner Speaker: Christine Wardell – Farm Girl to Businesswomen.
DAY TWO 25TH APRIL 2020
9am Anzac Service Bannockburn
12 Noon Picnic lunch @ Lake Dunstan waterfront
1pm Wine trail
4BARRELS WINE TRAIL – This can be walked (8km) or
Transport can be provided.
Transport required: Yes/No
or
45 degrees Parallel walk (2Km with 501 steps)
Please circle which option you wish to go on.
5pm Friendship hour at The Gate – Cash Bar
6pm Dinner at The Gate Cromwell
Speakers Judge Emma Smith - Family violence
Judge Emma Parson – Drugs and Alcohol
DAY THREE 26TH APRIL 2020
9am Farmlands Breakfast at The Gate Cromwell
Speaker Pauline Blomfield (K9MD)
10.30am Bannockburn slicing walk (4km)
or Old Cromwell Township to Bannockburn cycle trial (11km return)
Please circle one option you wish to go on.
1pm Farewell Lunch at The Gate CromwellReserved Accommodation
We are reserving as much accommodation as possible at set rates as below
Please circle which accommodation you wish to stay at and type.
Type of accommodation required: Single Share Twin Apartment
Name of person/group you with to share with…………………………………………………………..
.
THE GATE 6 Barry Avenue Cromwell www.havesthotel.nz
30 rooms with a queen bed plus a single in each room, suitable for twin share
Reserved price $175.00 per room per night.
The Gate will donate 5% of each booking to K9MD
FALCON’S NEST 16 Silverstone Drive Cromwell www.falconsnest.co.nz
This facility offers group accommodation, with self-service communal kitchen.
3 rooms x 4 people
3 rooms x 6 people
Reserved price per person = $100 (24th- 26th April)
Heritage Collection Lake Resort 15 – 23 Perriam Place Cromwell www.lakeresort.co.nz
DOUBLE STUDIO 1 x King Bed – Upstairs Studio $149 per night
SUPERIOR DOUBLE STUDIO 1 x King Bed – Upstairs Studio $166 per night
TWIN STUDIO 2 x King Beds – Upstairs Studio $154 per night
SUPERIOR TWIN STUDIO 2 x King Beds – Upstairs Studio $173 per night
ONE BEDROOM VILLA one-bedroom full apartment $225 per night
1 x King Bed, full kitchen, dining & lounge. Large deck over marina, with lower deck on water level
FAMILY VILLA three-bedroom full apartment. $391 per night
3 x King Beds (separate rooms), full kitchen, dining & lounge. Large deck over marina, with lower
deck on water level
Please note: Named accommodation on registration must be booked by
Triple F Challenge 2020 Committee no later than 13th December
Reserved accommodation will be allocated on a first received basis.
We will notify you if you miss out on your selected accommodation choice to discuss options.CANCELLATION POLICY
Please let registration officer (Pat) know immediately if you are unable to attend.
Sorry but there will be no refunds after 24th March 2020
DIETARY REQUIREMENTS
Please specify……………………………………………………………………………………………………………..
……………………………………………………………………………………………………………………………………
HEALTH ISSUES
If you have a health or medical condition that may impact your wellbeing and safety
please advise and any medication/treatment…………………………………………………………….
…………………………………………………………………………………………………………………………………..
Please advise any allergies and treatment including epi-pen………………………………………
……………………………………………………………………………………………………………………………………
ADDITIONAL INFORMATION
Cash Bar will be available at the Dinners
If you are not bringing your own bike, Bike Hire is your own responsibility.
Bike it Now Cromwell for bike hire 0800 BIKE NOW (245366) Opposite i-site centre.
Saturday breakfast is not provided for.
You must bring your own or make your own arrangements.
Make sure to bring drink bottle and own sun protection and a backpack.
Raffles – winners will be drawn Saturday night 25th
Please note: Extra people Attending Saturday Night Dinner and/or Sunday farewell lunch will be at
their own cost.
NON-MEMBERS, HUSBANDS, PARTNERS, FRIENDS & FAMILY MEMBERS ARE ALL WELCOME.
Triple F Challenge 2020 Committee
Raewyn van Vugt 027 448 8957 whitegold@rivernet.co.nz
Margaret Pittaway 021 024 89569 lochlea@xtra.co.nz
Ainsley Webb 027 272 0386 jpwebb@xtra.co.nz
Pat Macaulay 027 201 6921 pat.macaulay@outlook.com
IF YOU HAVE ENQUIRIES PLEASE CONTACT ONE OF THE TRIPLE F CHALLENGE COMMITTEE MEMBERS
PLEASE NOTE – THIS IS A SMOKE FREE EVENTDUTY OF CARE and YOUR HEALTH & SAFETY
• All participants will take personal responsibility to prevent/avoid accidents and injury to
themselves or others.
• All participants are fully responsible for their own personal belongings. This includes if you choose
to bring your own bike.
• RWNZ, Region One, as coordinators of this event will not be held liable for any accidents, damage
or theft but will ensure to the best of our ability not to expose anyone to unnecessary risk.
• I confirm that I have a level of fitness and ability that supports our safe participation in the event.
• I confirm that I will adhere and follow all event organisers instructions during the event.
• I confirm that I agree to release event organisers and those people associated with the event of
any liability, financial or otherwise.
• I consent to the event organisers using and publishing still photography to promote a future event.
• I have read and agree to “Duty of Care & Your Health & Safety” policy of the
Triple F Challenge 2020
Signature of Participant……………………………………………………………….Date……………………………….
Signed by RWNZ…………………………………………………………………………..Date………………………………
Returned signed acceptance (date)………………………………………………………………………………………
REGISTRATION COSTS (AS PER YOUR SELECTIONS)
Registration per person (meals and incidentals) $250.00
Accommodation (name) ……………………………………………………(x …. nights) $...........
Extra people to Saturday (25th) Dinner $50 p.p……………..……(number…..x) $...........
Extra people to Sunday (26th) Farewell Lunch $25 p.p………. (number……x) $...........
TOTAL COSTS $...........
Internet banking
RWNZ TRIPLE F CHALLENGE WESTPAC MOSGIEL
03 1725 0097086 00 PLEASE INCLUDE YOUR NAME AS REFERENCE
PLEASE SIGN…………………………………………………………………….DATE……………………………………….
PRINT NAME………………………………………………………………………………………………………………………
NOTE:- Page 5 will be signed and scanned or posted back to you as
acknowledgement of your registrationYou can also read
