2024 Junior Brolgas Open Training and Trial Nomination Form

2024 Junior Brolgas Open Training and Trial Nomination Form

Please fill in the form below to nominate to play in 2024 Brolgas Pathway.
Key Dates:

QLD Country Championships: June 28th -30th, in Rockhampton
U14s & U16s Boys Emerging Reds Cup: September School Holidays
U13 Boys, U14 Girls & U16 Girls City v Country: September School Holidays

This form is for the Junior players who wish to attend the Brolgas Open Training Sessions and Brolgas Trials.
*Note that you MUST be a registerd club player in the 2024 TDRU Season in order to represent the Brolgas*
Age Group*

Under 12 Mixed (Born 2012)Under 13 Boys (Born 2011)Under 14 Boys (Born 2010)Under 14 Girls (Born 2010)Under 16 Boys (Born 2008)Under 16 Girls (Born 2008)
Player information

Please fill in the information below.
Players Name*

PrefixFirst NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Date of Birth *

MonthDayYear
Date
Current Club *
REGISTRATION STATUS 2023 (Note: players must be registered to attend Brolgas Trials)*
Preferred playing position/s *
Jersey Size (Mens or Ladies) as per sizes above (i.e. M or 14)*
Shorts Size (Mens or Ladies) as per sizes above (i.e. M or 14)*
Pre-existing injuries *
Allergies
Medications
Parent/Guardian details
Parent Name *

First NameLast Name
Phone Number*

Area CodePhone Number
Phone Number

Area CodePhone Number
E-mail*
Consent form

by signing below I consent for my child to participate in the Junior Brolgas-Country Pathways Program
Signature

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Email
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2024 Junior Brolgas Open Training and Trial Nomination Form

Player information

Parent/Guardian details

Consent form