SWVFA Dispensation Request Form

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SWVFA Dispensation Policy & Request Form

South West Victorian Football Administration (SWVFA) wish to advise the release of the SWVFA Dispensation Policy & Request Form. The purpose of the policy is to provide all stakeholders with a clear and concise process for dispensation requests amongst the SWVFA competitions.

The Dispensation Policy & Request Form allows Clubs to submit a request for a player(s) to be granted exemption by SWVFA to participate in competitions that they would otherwise not be eligble for.

The following SWVFA Dispensation Request Form is the formal process by which Clubs can submit dispensation requests for the relevant player(s). Only Club representatives can submit this Jotform, not individual players/parents.

Please ensure that prior to submitting a dispensation request you are equipped with the following:

FA ID Number - to progress through the process the player must have an FA ID number. Please contact the Football Victoria registrations department via registrations@footballvictoria.com.au for any queries regarding a player's FA ID number.

all relevant information required to be submitted; and

any relevant documentation, as per the Dispensation Policy

To be considered to participate in an upcoming fixture the application must be submitted seven (7) days prior to the scheduled fixture date. Any application submitted less than seven (7) days prior to the scheduled fixture will not be considered for that specific round.

Once a Club representative has submitted a dispensation request, the SWVFA dispensation committee will review the request and provide an outcome to the Club representative. SWVFA will aim to provide the Club with communication regarding the request within seven (7) working days of submission.

It is important to note that Clubs submit dispensation application requests in accordance with the Dispensation Policy and via this form, however approval is not guaranteed, nor should Clubs anticipate approval prior to the dispensation request being considered and determined by SWVFA through the formal process.

Please note any Club that requests to submit further supporting documentation or information after the outcome of the reuqest has been determined will incur a 're-review' administrataive fee of $75 charged to the Club's account.
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Club Representative Details* This field is required.
Please Select
Please Select
Corangamite Lions
Hamilton Raiders
Port Fairy Plovers
Portland Panthers
Stawell Pioneers
Warrnambool Rangers
Warrnambool Wolves
Club Name
Club Representative First Name
Club Representative Last Name
Club Representative Email
Club Representative Phone Number
Please Select
Please Select
President
Secretary
General Manager/Administrator
Technical Director
Coach
Committee Member
Club Representative Role
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I acknowledge I am a Club Representative submitting a dispensation request on behalf of a player at my Club, where both the player and their parents/guardians know and understand I am submitting this dispensation request on the players' behalf.* This field is required.
YESNO
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I acknowledge I will provide true and accurate information throughout all questions and areas of the submission.* This field is required.
YESNO
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Player Details* This field is required.
Player First Name
Player Last Name
DOB (dd-mm-yyyy)
Player FA ID Number
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Parent/Guardian Details* This field is required.Please ensure a parent/guardian contact is provided for any player under the age of 18 years old. If the player is 18+ years old please include their contact details below.
Parent/Guardian First Name
Parent/Guardian Last Name
Parent/Guardian Email Address
Parent/Guardian Phone Number
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Please select which competition the respective player is requesting to participate in for season 2023.* This field is required.
MiniRoos Boys or Girls (U7 - U11)
Junior Boys (U12 - U18), Junior Girls (U12 - U18) or Junior Mixed (U12 - U18)
Senior Women's
Senior Men's
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MiniRoos Competitions (U7 - U11) - Please select which dispensation you wish to submit an application for.* This field is required.Note: Dispensation for this level of competition is only required to be submitted for players that wish to play in MiniRoos competitions however are not age eligible for Under 11’s. This is specific to a player who is turning 12 during the respective calendar year and is not age eligible for the Under 11 MiniRoos competition.
Medical Dispensation
First Year Dispensation
Play Football Dispensation
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Junior Boys (U12 - U18), Junior Girls (U12 - U18) or Junior Mixed (U12 - U18) Competitions - Please select which dispensation you wish to submit an application for.* This field is required.
Medical Dispensation
First Year Dispensation
Above Age Dispensation (request to play 4 years above the players age eligible age group)
Gender Dispensation
Play Football Dispensation
Finals/Play-Off Eligibility Exemption Dispensation
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Senior Women's Competition - Please select which dispensation you wish to submit an application for.* This field is required.
Senior Women Age Dispensation
Gender Dispensation
Finals/Play-Off Eligibility Exemption Dispensation
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Senior Men's Competition - Please select which dispensation you wish to submit an application for.* This field is required.
Senior Men's Age Dispensation
Gender Dispensation
Finals/Play-Off Eligibility Exemption Dispensation
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MEDICAL DISPENSATION OVERVIEW

SWVFA recognises that it may be necessary in some circumstances to provide dispensation for an individual to play in an SWVFA competition a maximum of one (1) year below their age due to a physical disability, mental disorder or physical size development consideration as identified and diagnosed by a certified medical practitioner.

A certified medical practitioner is a medical specialist who has attained the appropriate qualifications and accreditations to practise and includes both sports physicians and paediatricians.

The Club must provide SWVFA with the following documentation in support of their application for medical dispensation.

A supporting letter from the players parent (s) or guardian

Current (within 12 months of the application unless evidencing a chronic condition) medical evidence to support the application from the players medical specialist detailing the need for dispensation ; and

Any other information the club wishes to submit in support of the application.
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Please provide a supporting letter from the players parent(s) or guardian(s).* This field is required.
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Please provide medical evidence to support this application from the players medical specialist detailing the need for dispensation.* This field is required.A certified medical practitioner is a medical specialist who has attained the appropriate qualifications and accreditation to practise and include both sports physicians and pediatricians.
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FIRST YEAR DISPENSATION OVERVIEW

A first-year dispensation may be granted to a player who has not previously been registered with FA, FV or SWVFA. This form of dispensation is to allow an individual to play in an SWVFA competition for which the usual eligible age is a maximum of one (1) year below the player’s age and is only valid for one competition season. Dispensation is only granted for players to play down one age group. Requests to play down two or more age groups are not permitted. This dispensation cannot be reapplied for the following competition season or any other season following the player’s first season participating in an FA, FV or SWVFA competition.

SWVFA may in its sole discretion refuse to grant a dispensation request under this regulation in circumstances where the player in question has played football in school or other competitions not administered by SWVFA, FV or FA. SWVFA may seek further information from the Club in question before deciding under this regulation and the Club must submit that information as part of the dispensation request.

A first-year dispensation may be refused or revoked by SWVFA acting in its sole discretion if SWVFA later discovers that the Club did not provide relevant and/or requested information without a reasonable excuse.
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Has the player previously been registered with Football Australia (FA) or Football Victoria (FV)?* This field is required.
YESNO
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Did the player/Club submit a First Year Dispensation Request in season 2022?* This field is required.
YESNO
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Is this First Year dispensation request to play down one (1) age group?* This field is required.Requests to play down two or more age groups are not permitted.
YESNO
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Do you acknowledge this is a one (1) year dispensation and the player will not be able to apply for a First Year dispensation the following year? * This field is required.
YESNO
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PLAY FOOTBALL DISPENSATION OVERVIEW

A play football dispensation may only be granted in exceptional circumstances where there are no reasonable alternatives available to the player and in the opinion of SWVFA, it benefits the interests of one or more of the following to allow the dispensation:

the player;

the Team;

the Club;

the League in which the Team participates;

football in Victoria in general.

Play football dispensation is only granted for players to play down one age group. Requests to play down two or more age groups are not permitted.

If granted, the play football dispensation is a one year ‘bridging dispensation’ to allow the Club to take reasonable steps to prepare the player to play in their rightful age group the following season. It is envisaged that this dispensation will not be required for the following year.
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Is this an exceptional circumstance where there are no reasonable alternatives available to the player?* This field is required.
YESNO
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Has the player previously been granted a Play Football Dispensation by SWVFA or FV?* This field is required.
YESNO
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Does the Club have an age eligible age group for this player to participate in?* This field is required.
YESNO
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Is this play football dispensation request to play down one (1) age group?* This field is required.Requests to play down two or more age groups are not permitted.
YESNO
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In support of this application and in line with the Dispensation Policy, please submit a document on Club letterhead including the following: an explanation of how the player has no reasonable alternative(s) available, if dispensation was granted, how this would benefit the interests of the player, Team, Club, League in which the Team participates and/or football in Victoria in general, and an explanation of how the Club is going to take reasonable steps to prepare the player to play in their rightful age group the following season.* This field is required.If all three (3) requirements are not met in the attached document, FV will be unable to consider this application.
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Do you acknowledge if granted, the play football dispensation is a one (1) year 'bridging dispensation' and it is envisaged that this dispensation will not be required for the following year?* This field is required.
YESNO
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PLAY FOOTBALL DISPENSATION OVERVIEW

A play football dispensation may only be granted in exceptional circumstances where there are no reasonable alternatives available to the player and in the opinion of SWVFA, it benefits the interests of one or more of the following to allow the dispensation:

the player;

the Team;

the Club;

the League in which the Team participates;

football in Victoria in general.

Play football dispensation is only granted for players to play down one age group. Requests to play down two or more age groups are not permitted.

If granted, the play football dispensation is a one year ‘bridging dispensation’ to allow the Club to take reasonable steps to prepare the player to play in their rightful age group the following season. It is envisaged that this dispensation will not be required for the following year.
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Please provide a signed letter from the player's Club President supporting the application.* This field is required.
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Please provide a signed letter from the player's Club Technical Director supporting the application.* This field is required.
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Please provide a signed letter of consent from the player's parents(s) or guardian(s) supporting the application. * This field is required.
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Please provide a document listing general medical details of the player by a medical professional including height and weight.* This field is required.A certified medical practitioner is a medical specialist who has attained the appropriate qualifications and accreditations to practise and includes both sports physicians and paediatricians.
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GENDER DISPENSATION OVERVIEW

Under the Victorian Equal Opportunity Act, it is unlawful to discriminate on the ground of gender up until the age of 12 years.

The SWVFA allows players to play in gendered competition of their choosing under the following guidelines:

Players who identify as non-binary, transgender or intersex are permitted to participate in the competition of their choice, up to the age of U12 for a girl’s competition, and up to the age of U13 for a boy’s competition.

Players who identify as male are permitted to play in female competitions in accordance with the Equal Opportunity Act 2010 up until Under 12 girls. The player must turn 12 or below during the 2021 calendar year and may play in their equivalent age group of female competitions without the prior approval of FV.

Players who identify as female are permitted to participate in male competitions up until Under 13 boys. The player must turn 13 or below during the 2021 calendar year and may play in their equivalent age group of male competitions without the prior approval of SWVFA.

Players who identify as female are not permitted to participate in male competitions from Under 14 and above with the exception of the player receiving prior written approval from the FA Technical Department.

The Club must provide SWVFA with the following documentation in support of their application for gender dispensation in relation to a regional player and/or an FA-approved player;

A signed letter from the player’s Club president supporting the application

A signed letter from the player’s Club Technical Director supporting the application

A signed letter of consent from the players parent (s) or guardian supporting the application

A document listing general medical details of the player by a medical professional including height and weight; and

Any further information requested

Players who have affirmed their gender identity by transitioning to a gender that is different to their sex assigned at birth; are in the act of transitioning via gender affirming practices; or are non-binary people, are eligible to nominate to play in a competition of their choosing conducted for their affirmed gender and not sex assigned at birth, unless it is gives cause to a risk to themselves or others.

Note: SWVFA may request supporting documentation as part of any application under these guidelines and applicants may be referred to FA’s policy.

All decisions in relation to the gender rules are final and at the discretion of the SWVFA with the assistance of the FA & FV diversity and inclusion team, technical team and FV regional team. These decisions are not appealable.
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Please select which Gender Dispensation you are requesting.* This field is required.
Players who identify as female requesting to play in male competitions from Under 14's and above.
Players who have affirmed their gender identity by transitioning to a gender that is different to their sex assigned at birth, are in the act of transitioning via gender affirming practises, or are non-binary people. Requesting to play in a competition of their choosing conducted for their affirmed gender and not sex assigned at birth.
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Has the player received prior written approval from the FA Technical Department?* This field is required.
YESNO
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Please provide a signed letter from the player's Club President supporting the application* This field is required.
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Please provide a signed letter from the player's Club Technical Director supporting the application.* This field is required.
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Please provide a signed letter of consent from the player's parent(s) or guardian(s) supporting the application.* This field is required.
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Please provide a document listing general medical details of the player by a medical professional including height and weight.* This field is required.A certified medical practitioner is a medical specialist who has attained the appropriate qualifications and accreditations to practise and includes both sports physicians and paediatricians.
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Please provide SWVFA with a brief explanation of the respective player and the reasoning for dispensation request.* This field is required.Once submitted, FV may be in touch with the Club to gain further information from the player or Club regarding the dispensation request.
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FINALS/PLAY-OFF ELIGIBILITY EXEMPTION DISPENSATION OVERVIEW

SWVFA will only consider dispensation in exceptional circumstances and where a Club/Team can establish it is unable to field a team for a final due to insufficient player numbers as a result of unavailability (including injury). Any Club wishing to apply for a finals/playoff eligibility exemption dispensation must apply to SWVFA:

In writing;

At least five (5) working days before the final is due to take place;

Setting out the grounds on which it requests a dispensation be granted;

With evidence to support player unavailability; and

Providing SWVFA with any further information required and/or requested.

All competitions

A finals/playoff eligibility exemption dispensation may be granted to allow a player that has played less than five (5) Regular Season Competition Fixtures to qualify for finals/playoff fixtures.
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Is the Club currently unable to field a team for a final due to insufficient player numbers as a result of unavailability (including injury)?* This field is required.
YESNO
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Please set out the grounds on which the Club requests this dispensation to be granted by SWVFA. If due to injury please provide medical evidence from a medical practitioner to support player unavailability.* This field is required.A certified medical practitioner is a medical specialist who has attained the appropriate qualifications and accreditations to practise and includes both sports physicians and paediatricians.
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SENIOR WOMENS AGE DISPENSATION OVERVIEW

A senior women’s age dispensation may be granted in relation to a player who is under the age of 14 years old as of 1 January in the year of that relevant competition season and is requesting to play in a Senior Women’s Competition.

The Club must provide SWVFA with the following documentation in support of their application for senior women’s age dispensation.

a signed letter from the player’s Club president supporting the application

a signed letter from the player’s Club Technical Director supporting the application

a signed letter of consent from the players parent or guardian supporting the application

a document listing general medical details of the player by a medical professional including height and weight; and

any further information requested by SWVFA.
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Please provide a signed letter from the player's Club President supporting the application* This field is required.
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Please provide a signed letter from the player's Club Technical Director supporting the application.* This field is required.
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Please provide a signed letter of consent from the player's parent(s) or guardian(s) supporting the application.* This field is required.
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Please provide a document listing general medical details of the player by a medical professional including height and weight.* This field is required.A certified medical practitioner/professional is a medical specialist who has attained the appropriate qualifications and accreditations to practise and includes both sports physicians and paediatricians.
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GENDER DISPENSATION OVERVIEW

Players who identify as female are not permitted to participate in Senior male competitions, with the exception of any player who receives prior written approval from FV.

Players who have affirmed their gender identity by transitioning to a gender that is different to their sex assigned at birth; are in the act of transitioning via gender affirming practices; or are non-binary people, are eligible to nominate to play in a competition of their choosing conducted for their affirmed gender and not sex assigned at birth, unless it is gives cause to a risk to themselves or others.

Note: SWVFA may request supporting documentation as part of any application under these guidelines and applicants may be referred to FA’s policy.
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Gender Dispensation* This field is required.
Female Player seeking to play in Senior Men's Competitions
Players who have affirmed their gender identity by transitioning to a gender that is different to their sex assigned at birth, are in the act of transitioning via gender affirming practises, or are non-binary people. Requesting to play in a competition of their choosing conducted for their affirmed gender and not sex assigned at birth.
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Please provide SWVFA with a brief explanation of the respective player and the reasoning for dispensation request.* This field is required.Once submitted, SWVFA may be in touch with the Club to gain further information from the player or Club regarding the dispensation request.
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SENIOR MEN'S AGE DISPENSATION OVERVIEW

A senior men’s age dispensation may be granted in relation to a player who is under the age of 15 years old as of 1 January in the year of that relevant competition season and is requesting to play in a Senior Men’s Competition.

The Club must provide SWVFA with the following documentation in support of their application for a senior men’s age dispensation:

a signed letter from the player’s Club president supporting the application;

a signed letter from the player’s Club Technical Director supporting the application;

a signed letter of consent from the player’s parent or guardian supporting the application;

a document listing general medical details of the player by a medical professional including height and weight; and

any further information requested by SWVFA.
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Please provide a signed letter from the player's Club President supporting the application.* This field is required.
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Please provide a signed letter from the player's Club Technical Director supporting the application.* This field is required.
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Please provide a signed letter of consent from the player's parent(s) or guardian(s) supporting the application.* This field is required.
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Please provide a document listing general medical details of the player by a medical professional including height and weight. * This field is required.A certified medical practitioner/professional is a medical specialist who has attained the appropriate qualifications and accreditations to practise and includes both sports physicians and paediatricians.
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South West Victorian Football Association Inc (SWVFA)

Privacy Collection Notice

In this form, you are asked to provide South West Victorian Football Association Inc. ABN 22 303 634 795 (‘SWVFA’) with personal information (which may include sensitive information). SWVFA regards the management of personal information in an open and transparent way as a priority. SWVFA collects personal information (including through Football Australia’s (‘FA’s’) Play Football National Registration System (‘Play Football’)) for various reasons, including:

· for the organisation, conduct and promotion of football competitions, matches, programs and products and related objects set out in SWVFA’s constitution;

· to process registration of individuals to participate in football competitions, matches, programs and products, as a player, official or otherwise;

· to identify, create and provide services and benefits, some of which may be provided by or in conjunction with FA, government agencies or other SWVFA partners or affiliated or associated entities, or through Football Victoria's (FV’s) GO Football website;

· to communicate with you and other stake-holders to provide football related information and offers from football administrators or other SWVFA partners (both commercial and not-for-profit);

· to maintain participation and service/benefit records, data and statistics, including for archive and historical purposes;

· to identify, create and provide services to registered participants, officials, clubs, club members, zones, supporters, students, and members of the public, which may occasionally warrant direct marketing of these services (unless you opt out of any such direct marketing);

· to satisfy its obligations and comply with applicable statutes, regulations and policies as an affiliate of FV which is a Member Federation of FA and the international governing body FIFA;

· in relevant cases, and with your consent where the information is sensitive information, for research and/or review, including for the purposes of assessing performance, health or injury including in SWVFA, FV and FA’s (Victorian) talented player programs, to research participation in football or target funding; and

· to satisfy its obligations under the Associations Incorporation Act 1981 (Vic) and otherwise at law.

Further information about accessing and correcting your details or making a complaint are available in SWVFA’s Privacy Policy. By completing and submitting his form, you consent to the collection, use and disclosure of your personal information as described above and as set out in SWVFA’s Privacy Policy.
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SWVFA Dispensation Policy & Request Form