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I agree to Athletics New Zealand passing this medical profile and associated personal details, provided by me for the purposes of my personal wellbeing and care, to the appointed Athletics NZ staff, Team management and/or Athletics NZ Touring staff, for use in relation to a medical or health emergency or similar.
I understand that the information contained in this form is otherwise confidential and can only be released with my consent.
I confirm that I am submitting an accurate account of my medical information
Please note: Submission of this form is considered as being a signed agreement.