Entry Form: New Zealand MTB-Orienteering Championship 2001
Contact Name
	Phone	
Street Address

Email Address
	
Send Final Details and Results by EMAIL or POST?		

First Name	Last Name	Orient.Club	Birth Year	Class Champ	Class Score	Entry Fee	

							
							
Use the discounted entry fee if you are already an orienteering club member.	Ordinary Total $		
Add the late fee after 10 September.	Late Fees		
Cheques to “Hutt Valley OC”. Post to “MTBO Champs”, Box 30 398, Lower Hutt	Total $