Optimize PDG Ltd
13 Pupuke Road
Takapuna 0622

E-mail Optimize

Mob: +64 21 977 731
Office: +64 9 486 3562

Optimize Performance Development Group

"The achieivements of an organisation are the results of the combined effort of each individual."
- Vince Lombardi

TRIATHLON TRAINING CAMP Registration

Saturday November 20 & Sunday November 21 2010 Takapuna

Name:	*
Age or Age Group (5 year block):
Cell Phone:	*
Email:	*
Emergency Contact Detail:
Name:
Phone:
Special Dietary Requirements:
Special Medical Requirements:
Disclaimer: Submitting this form will be acknowledgment that you have read and understood the disclaimer.	I understand that participation at this camp is voluntary and whilst every care will be taken by the coaches regarding personal safety I am ultimately responsible for my own safety and welfare.
Name of parent or guardian if under 18:
* = required