Athlete Nomination Form for 2024 NZ Elite Para Team

Please fill out this form to nominate for the 2024 NZ Elite Para Team selection trials.

Nomination forms close on 11 December 2023

You need to please submit a 3km erg test (open rate) before 11 December 2023, as part of this nomination form.

In 2024 you will be required to submit an updated 2km erg score completed between 22 - 28 January 2024. You will be able to submit this score through a link on the RNZ website.

If you have missed the deadline for this nomination form please email Judith Hamilton - judithh@rowingnz.kiwi

Question Title

* 1. Athlete details

Name

Gender

Date of birth

Address

City/Town

ZIP/Postal Code

Email Address

Phone Number

Question Title

* 2. Current club and school/university your are representing

Question Title

* 3. Passport details

Name

Expiry date

Passport number

Question Title

* 4. Coach details

Name

Email Address

Phone Number

Question Title

* 5. Para Classification

PR3

PR2

PR1

Unknown

Question Title

* 6. Do you scull?

Yes

Question Title

* 7. Do you row bow?

Yes

Question Title

* 8. Do you row stroke?

Yes

Question Title

* 9. Which is your preference

Scull

Row bow

Row stroke

Question Title

* 10. Please enter information about your PB 2km Erg Test

Best 2km erg time (mm.ss.00)

Best 2km erg average watts/split

Date this erg test was completed

Witness by

Question Title

* 11. 3km Erg test completed before 11th December 2023

3km erg time (mm.ss.00)

3km erg average watts/split

3km erg average rate

Date this erg test was completed

Witness by

Question Title

* 12. Please upload a photo of your 2023 3km Erg Test Screen.

If you have any problems doing this please contact janey@rowingnz.kiwi

PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only.

Choose File

Question Title

* 13. I confirm that all information provided in this nomination form is true and correct at the time of completion

Yes