Athlete Registration Form
Boorloo NAIDOC Netball Carnival, 9th July 2024
Name
*
First Name
Last Name
Date of Birth
*
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Are you Aboriginal or Torres Strait Islander?
*
Aboriginal
Torres Strait Islander
Aboriginal and Torres Strait Islander
N/A
Emergency Contact Person Full Name
*
Emergency Contact Person Mobile Number
*
Is the athlete currently playing in the Albany Netball Association? If so, please provide details below? ie. Grade and Club Name, playing history and preferred positions
Does the athlete have any medical issues, injuries, or disabilities that we should be aware of? If so, please provide details
Does the athlete have any food allergies or intolerances that we should be aware of?
Do you give permission for the athlete's photos to be used and named in promotional activities on Netball WA, Albany Netball Association, Binalup Grassroots and any other affiliated websites and social media platforms that may be relevant?
Yes
No
Will you be travelling with the athlete to the carnival or will they require transportation to and from Perth (Gold Netball centre). Please note, we will try our best to accommodate all parties that need travel assistance to the event.
Yes
No
PLAYER DECLARATION: I hereby declare that as a player selected to represent Albany in the Binalup Grassroots team, I agree to attend all scheduled trainings as set by my coaching staff unless sick or absent from town. I agree to abide by the rules and code of conduct of Albany Netball Association, Netball WA and any other governing bodies that I am bound by. I agree to fully engage and respect my coach, teammates and all other officials that will be involved in attending this tournament and acknowledge that I will also be treated in the same manner.
By selecting this option, I agree to the above conditions and understand that my position on the team can be revoked if I do not abide by these conditions at all times.
Parent Signature
Date
/
Month
/
Day
Year
Submit
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