2024 BASL Dispensation Form

1

Club Name* This field is required.

2

Club Contact Details* This field is required.

Contact Name

Please enter your phone

Please enter your email

Club Role (i.e. President, Secretary, Junior Co-Ordinator)

3

Player Details* This field is required.

Player Name

Date of Birth

FFA Number

4

Competition Seeking Dispensation* This field is required.

Central Victorian Seniors

Central Victorian Juniors (Competitive) - Mixed

Central Victorian Juniors (Competitive) - Girls

Central Victorian Non-Competitive

5

Does your club have a team within the players correct age group?* This field is required.

YESNO

6

Is the request to play up beyond the maximum age allowed under the Rules of Competition for both Seniors and Juniors?

YESNO

7

The player agreement at the link below must be completed and attached to this application:

Player Agreement

8

Is the application to play down an age group as allowed within the Rules of Competition?If "Yes" please provide the medical information (where applicable) or additional information to enable assessment of the application.

YESNO

9

Is the medical information required attached? (Where applicable)As required under the Rules of Competition for playing down an age group.

YESNO

10

Additional InformationPlease provide any additional information in the space below.

11

File UploadEnsure any necessary attachments as required are provided here (i.e., Medical Information, Player Agreement).

Drag and drop files here

Select files to upload

Max. file size: 10.6MB

12

Note: Players seeking a dispensation (where required and within the acceptable reasons) must NOT play in any competition outside the Rules of Competition until approval in writing has been received from BASL.

Please ensure all required information and attachements are completed prior to submission.

Incomplete requests will be returned to the requesting club and not processed.

13

Thank you for your submission. BASL will provide a answer after the review of information provided.