HRCC Sports Individual Nomination Form

Sports Individual Nomination Form
This form is for individual nominations for the following Sport competitions:
- Ladies Netball
- Mixed Volleyball
Since you're nominating yourself as an individual player, our Senior Recreation Officer will do their best to match you with a suitable team. To facilitate this process, they may need to share some of your information with approved team captains.
Do you provide consent for our Senior Recreation Officer to share your details with approved team captains?:*

YesNo
Name:*
Age:
If under 16 years
Contact Number:*
Email:*
Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Sport:*
Preferred position/s (if nominating for netball):
Additional Information (if required):
How did you hear about our competition?*

Word of MouthSocial MediaIn-centre advertisingI've played at HRCC beforeOther
Do you give consent for your photo to be taken for promotional purposes by HRCC staff?*

YesNo
I would like to subscribe to receive HRCC news and updates at the email provided above

YesNo
Declaration:*

I have read and agree to the rules above
Signature:*

Clear
Date:*

MonthDayYear
Date
ADMIN USE ONLY
Received on:
Staff Name:
Nomination Fee Paid:

YesNo
Receipt Number:
Should be Empty: