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2017 NEW ZEALAND NATIONAL GYMSPORTS CHAMPIONSHIPS Notice of Intention to Trial for Canterbury GymSports Nationals Team – MAG This is to notify that I wish to be considered for the Canterbury GymSports Nationals Team travelling to the 2017 New Zealand National GymSports Championships.

Athlete Information

Name:

Address:

Phone:

Date of Birth:

Club:

GSNZ Code: MAG

Competition Competition (Manager to complete) Level/STEP/Grade: Number: Name of Coach:

Parent Information (used for all communication)

Name:

Address:

Phone:

Email:

Bank A/C number (Any refunds due will be paid to this account) Interest in Parent Helper Role? (Please circle if interested) Parent helpers are selected after the team is named in August Parent Helper

As there are costs incurred with organising a provincial team before selection is made a deposit will need to be submitted alongside this Intention to Trial Form for all MAG Gymnasts in Level 5 or above. This deposit will be refunded to you after the selection has been made should your son not make the team. For further information around the deposit please refer to the Athlete / Parent Handbook. Please return this form to your Code’s appointed Code Manager (refer to Athlete /Parent Handbook) via their email address or via physical copy and ensure your deposit is paid into GYMSPORTS IN CANTERBURY TRUST A/C, 03 1702 0360718 01 by May 3rd, 2017. Forms not returned or deposits not paid will mean gymnasts will not be considered for Canterbury selection.

CONSENT I give permission for

to be considered for selection for the Canterbury GymSports Nationals team which will attend the 2017 New Zealand Championships and by doing so also acknowledge that I have read the Canterbury Tour Guidelines and agree to act in accordance with these Tour Guidelines throughout the duration of the tour. Name of Gymnast Signed ______Date ______

Name of Parent Signed ______Date ______

Deposit Paid (please circle): Cash Internet Banking

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