Domestic License Form – Climbing New Zealand

To compete in Climbing New Zealand organised National events, you require a domestic license for the season you compete in.

To be eligible to be selected into a New Zealand Team you must be a member of a Regional Club affiliated to CNZ.

If a member of an affiliated club, your club will arrange for the payment of domestic license fee.

If you wish to compete in a CNZ event and you are not a member of an affiliated club you must still complete a domestic license form, and an additional charge will be levied during event registration.

Obligations of Competitors:

By applying for a Domestic License I acknowledge the rules of Climbing New Zealand (hereby known as CNZ) and commit myself to following these rules.

I have joined the club listed on this form and agree to abide by their rules and regulation.
I understand and abide by the regulations and rules of the sport and observe the principles of good sportsmanship.
I will accept, subject to the official appeal procedure, the decisions of the official judges without question or protestation and exercise self-restraint at all times.
I will abide by the anti-doping policy of CNZ, refer to website for details: https://www.climbing.nz/anti-doping-information/
I will retain my membership numbers and display them in accordance with the competition rules and regulations at all National Competitions.
I will treat other competitors, officials and others involved in the practice of the sport with full and due respect at all times, both during and outside a competition.
I accept that Indoor climbing carries with it some degree of risk. Knowing of the risks involved I accept that CNZ cannot guarantee my safety and I still wish to compete at the National Competitions so I expressly agree to assume the risk of injury or damage or death while participating in this activity.
I consent to receive medical treatment which may be deemed to be necessary by CNZ in the case of injury, illness or accident during the course of competing and also agree to indemnify CNZ in respect of such medical treatment.
I release, waive and hold harmless CNZ from all claims, losses, damages or expenses during or in conjunction with my participation in any National Competition. To the extent permitted by law, all liability for damage to property, nervous shock or mental injury is excluded together with any costs including legal fees that may be incurred as a result of any such claims, losses, damages or expenses.

I agree that CNZ may:

Share the information that I provide to it with WADA and any other anti-doping organisation.
Publish any disciplinary or appeal decision concerning me (including on its website)
Record my image by any types of equipment (video, photo etc.) and use it for any purpose in relation to and in connection with the interests of sport-climbing.
Use my email address to send me the CNZ newsletter and other related information and provide my email address to sponsors of events that I enter.

First name

Last name

Gender

Phone Number

Date of birth

Athlete Height

Athlete Armspan

Club Membership

License Number (if none - fill with 0 | for CNZ to add later)

Ethnicity

Athletes email address

If applicable: Caregiver email address; repeat your email if not applicable

Are you eligible for NZ Selection:
(For NZ Selection you need to hold a NZ Passport or be eligible to hold one)

Additional notes re. health and medical

Emergency Contact Name

Emergency Contact relationship

Emergency Contact Mobile

Please note: Once you complete the license form, you are confirming that all the information is true and correct.

If the athlete is a minor (under 18) or has a disability preventing them to fill out this form, a parent or guardian shall sign together with/or on behalf of the athlete.