WAIVER FORM
Ōmokoroa Dash 2026 (Sanctioned)
Ōmokoroa Domain, Ōmokoroa
Feb 21, 2026
Paddler Name
WAIOMIO, Sharma
Date of Birth
*
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Validate Date of Birth
2. Read terms and conditions
test
3. Emergency Contact
Emergency Contact Name
Relationship eg Wife / Husband / Daughter
Emergency Contact Phone
4. Agree to terms and conditions
Paddler is under 18, so a parent or guardian will need to sign on behalf
Parent / Guardian Name
Your Name
Signature
*
Please draw your signature below with your finger or mouse.
Clear Signature
Submit Waiver