Track Registration 2020/21 NAME: *Enter your nameLICENCE NUMBER: *CA Race licence number if applicable or n/aGRADE *Usual Grade if applicable (riders only)SENIOR-ASENIOR-BSENIOR-CSENIOR-DSENIOR-ESENIOR-FJUNIOR-AJUNIOR-BJUNIOR-CJUNIOR-DJUNIOR-EJUNIOR-FLITTLE TRAKEEZVOLUNTEERUNKNOWNOTHERLICENCE CATEGORY: Enter your licence categoryCLUB: ADDRESS LINE 1: ADDRESS LINE 2: PHONE NUMBER 1: PHONE NUMBER 2: EMAIL: *IMAGES: I authorise SCC to appropriately use my image for media release (optional)YesNoEVENTS: I authorise SCC to contact me about upcoming events (optional)YesNoVOLUNTEERING: Please contact me about volunteering at track events during the summer season (optional)YesNoEMERGENCY: I authorise Officials (Sports Trainer, St John Officer) to contact the below person(s) in any event deemed an emergency.YesNoCONTACT NAME 1: RELATIONSHIP 1: CONTACT PHONE 1: CONTACT NAME 2: RELATIONSHIP 2: CONTACT PHONE 2: CONFIRMATION: *Tick this option to confirm all details are correct and accept that SCC will use my information appropriately and only for the intended purpose.I accept - press submit button when complete VerificationPlease enter any two digits *Example: 12This box is for spam protection - please leave it blank:
