2025 Unisport Nationals

2025 Unisport Nationals

Personal Information
Full Name*

First NameLast Name
E-mail*
example@example.com
Phone Number*
Student ID Number*
FAN*
Date of Birth*

DayMonthYear
Date
Gender*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Course of Study*
Expected year of study completion*
Participation Status*

AthleteTeam ManagerTeam CaptainOther
Event*

AthleticsTriathlonSwimmingIndigenous NationalsDistance RunningT20 CricketNationalsSnowCross Country
Choose Athletics Event*

100m200m400m800m1500m5,000m10,000m4 x 100m Relay4 x 400m4 x 400m Relay3,000m Steeple5,000m Walk100m Hurdles400m HurdlesLong JumpPole VaultHammerHigh JumpDiscusTriple JumpShot PutJavelin
Choose Snow Event*

Alpine & Snowboard Giant SlalomAlpine & Snowboard Super GSki Cross & Snowboard CrossSki Slopestyle & Snowboard SlopestyleAlpine Cross CountrySki & Snowboard Rails
Chosen Nationals Sport*

Basketball - MensBasketball - WomensBeach Volleyball - Womens PairsBeach Volleyball - MixedBeach Volleyball - Mens PairsJudo - WomensJudo - Men'sKendo - MensKendo - WomensNetball WomensVolleyball - MensVolleyball - Womens
Medical Information
Medicare Number*
Medicare Reference Number*
Medicare Valid Date*

DayMonthYear
Date
Health Care Provider & Membership Number*
Emergency Contact*

First NameLast Name
Relation*
Mobile Number*
Please enter a valid phone number.
Work Number*
Please enter a valid phone number.
Pre-existing Health Condition(s)*
Medication to travel with (i.e puffer for asthma)*
Allergies*
Current/Niggling Injuries*
Bank Details (For uniform bond refund if required)
Account Name:*
BSB:*
Account Number:*
Additional Info
Polo / Competition Shirt Size*

Men - XSWomen - XSMen - SWomen - SMen - MWomen - MMen - LWomen - LMen - XLWomen - XLMen - 2XLWomen - 2XLMen - 3XLWomen - 3XLMen - 4XLWomen - 4XL
Competition Shorts Size*

Men - XSWomen - XSMen - SWomen - SMen - MWomen - MMen - LWomen - LMen - XLWomen - XLMen - 2XLWomen - 2XLMen - 3XLWomen - 3XLMen - 4XLWomen - 4XL
Please attach: Flinders University Participation Agreement (Step 2)*

Cancelof
I have read and understood the Participation Agreement, therefore by ticking the box, I agree to the Terms & Conditions outlined.*

I Agree
Signature*

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Should be Empty:

Medical Information

Bank Details (For uniform bond refund if required)

Additional Info