Wellington City Council

Sport Development Programme

Athlete Application Form

SECTION A – PERSONAL INFORMATION

1. ATHLETE CONTACT DETAILS:

Name*

First NameLast Name

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Email*

example@example.com

Mobile Phone Number*

Area CodePhone Number

2. SCHOOL DETAILS:

Name of School*

School Year Level (In 2024)*

3. SPORT INFORMATION:

What are the sports you are focusing on as part of this programme?*

Do you belong to any sports clubs? if so please name them*

4. COACH/ATHLETE SUPPORT DETAILS:

This is the person who is your coach or supports you in your sport (this could be your School Sports Coordinator/Director of Sport or Regional Sports Organisation if you don't have a specific coach for your sport)

Coach/Athlete Support Name*

First NameLast Name

Mobile Phone number*

Area CodePhone Number

What is your role? (Coach, Sports Coordinator etc)*

What club/organisation are you with*

Email*

example@example.com

COACH/ATHLETE SUPPORT REQUIREMENTS

As coach/athlete support person for this athlete, I have read and fully understand the requirements of my athlete, as set out in the athlete requirements. In doing so I acknowledge that in the instance where WCC Sport Development programme commitments coincide with athlete training and/or minor competition commitments, WCC Sport Development obligations will take priority. Attendance at major competitions, resulting in programme absence, should be discussed with Nuku Ora prior to the event.

PLEASE NOTE As coach/support person there will be a requirement to attend the Individual Performance Plan (IPP) session that your athlete will attend as well as the introductory session being held with all the athletes, families, and athlete support personnel.

There will also be opportunities for you to attend Coaches workshops relevant to this programme throughout the year. You will be placed on a mailing list to be advised of these on a regular basis.

Signature of Coach/Athlete Support person*

SECTION B – PERFORMANCE / COMPETITION INFORMATION

What team/s or programmes are you currently involved in? (Please note down all the sport activities you are involved in)*

Have you had any notable results/performances in the last two years that have made you want to pursue your sport further? If so, what were they?*

2024 and beyond sporting goals/ambitions: Briefly outline your sport performance goals. Where do you want to get to?*

What do you believe are your strengths that will assist in achieving these goals?*

What do you think you need help with to achieve these goals?*

What do you want to get out of participating in this programme?*

Do you have any questions or concerns regarding participating in the programme? (please type N/A if you don't)*

Are there any barriers to participation that we should be made aware of? E.g., transport to/from workshops? (Please type N/A if not applicable)*

Do you have medical conditions or injuries that we should be aware of?*

SECTION C – ATHLETE DECLARATION:

In submitting this application, I certify that the information provided is accurate and complete.

Athlete Signature*

Parent/Guardian name:*

First NameLast Name

Parent/Guardian Signature*

Your Privacy: WCC/Nuku Ora will record the personal details that are provided on this application form to fully consider your application. This information may only be accessed by WCC and Nuku Ora personnel. You have the right to inspect and update your details at any time. Please contact Nuku Ora on 04 380 2070