Special Request for Competitions
This form is to be used to make requests for special requests at GNSW competitions, including requests for Injury Petition.
Club Name
*
Club Email
*
Club Contact
First Name
Last Name
Event Name
*
Event Date
*
/
Day
/
Month
Year
2 digit day, 2 digit month, 4 digit year
Date
Gymsport
*
ACRO
AERO
GfA
MAG
RG
TRP
WAG
Please choose the Gymsport
Name of applicant
*
First Name
Last Name
Gymnast's Name
First Name
Last Name
Gymnast's Name
First Name
Last Name
Gymnast's Name
First Name
Last Name
Gymnast's Name
First Name
Last Name
Gymnast's Name
First Name
Last Name
Request
*
Injury petition - Must attach Medical Form and request details
Permission to leave before Presentation Ceremony
Other
Medical Certificate
Browse Files
Attach the Medical Certificate and supporting details here
Cancel
of
Reason for missing Presentation Ceremony
Supporting Information
Include supporting information for your Special Request
Supporting Information
Include supporting information for your Special Request
Supporting Documentation
Browse Files
Attach any Supporting Documentation for your request
Cancel
of
Submit
Should be Empty: