HSA 013 - Intra-Association Trial Match Request Form

Intra-Association Trial Match Request Form

HSA 013
This form must be submitted at least 2 days prior to the intra-association trial match.
Requesting Club Details:
Club*
Requested by*

First NameLast Name
Club Position*
Email*
example@example.com
Phone Number*
Opposition Club Details:
Club*
Club Contact*

First NameLast Name
Club Contact Position*
Email*
example@example.com
Phone Number*
Trial Match Details:
Age Group*
Match Date *

DayMonthYear
Date
Kick Off Time*

:HourMinutesAM/PM Option
Venue*
Has a Referee been appointed?*
If so, Name of Referee*
NOTE:

1. This form must be completed when a HSA team or club wishes to play trial matches against another HSA team or club.

2. This form must completed by both HSA clubs.

3. Trial matches must only be played on approved grounds suitable for football.

4. Grounds must be inspected and goalpost safety checked by the host club prior to usage.

5. Only players registered to a member Football NSW Club will be covered for sporting injuries.

6. Trial matches must be approved by the HSA Board for Public Liability coverage to apply.

7. A paper team sheet must be completed with all players and officials listed prior to the commencement of the match.
Should be Empty:

Intra-Association Trial Match Request Form