GOLDEN GROVE NETBALL CLUB INC. TRIAL NOMINATION FORM WINTER SEASON 2009 A nomination fee of $50.00 per player must accompany this form. Your nomination will not be accepted otherwise. This payment will be deducted from your season fees if you are successful in being selected into a team, or refunded to you should your nomination be unsuccessful. Please complete all sections on both sides of this form, and sign as your nomination can not be accepted without a signature. PERSONAL DETAILS Given Name: Surname: Date of Birth: ___________________ Address: ______________________________________________ Post Code: ________ Telephone: Home: _____________________ Mobile: ___________________________ Email: ____________________________________ Do you suffer from any medical conditions? __________ Details: _________________________________________________________________ Are you taking any medication? __________ Details: __________________________________________________________________ PLEASE COMPLETE OVER PAGE Office Use Only Payment Details CASH / CHEQUE PAID RECEIPT NUMBER Signed (Authorised Committee member) PLAYER NAME: __________________________________ GRADE Age is at the 31ST December 2009. Please tick only one. Senior Open age ( ) Intermediate 17 years and under ( ) Junior 15 years and under ( ) Sub Junior 13 years and under ( ) Primary 11 years and under ( ) Sub Primary 9 years and under ( ) POSITION USING the numbers ONE and TWO please indicate your first and second preferences for playing positions at trials. Please note, the club reserves its right to place you in a position with in a team other than the one you nominated, should team balance require it. Goal Shooter ( ) Which other positions have you played? Goal Attack ( ) Wing Attack ( ) _______________________________ Centre ( ) Wing Defence ( ) Goal Defence ( ) Goal Keeper ( ) Which club are you playing for during Summer season 08/09? ___________________________ Which grade are you playing during Summer 08/09? ___________________________ Please provide a brief playing history__________________________________________________ ________________________________________________________________________________ Are you trialing for any other clubs? __________________ • All new players will receive information on player, parent and spectator expectations and codes of conduct. • I am aware of the trials and selection processes adopted by the Golden Grove Netball Club and understand that I will be required to train during the season. • I agree to players with body piercing being required to complete an Association Indemnity form. This form is non specific in its content thus non intrusive, but required. • No personal information provided to the club will be given to any persons without their written permission. Team lists and contact phone numbers are supplied to the coaches and executive committee members. Team lists and ages are supplied to SADNA and SANA. • Players leaving their team part way through a season will be required to complete their financial obligations. Injury will be taken into consideration when calculating outstanding fees or refunds. • I understand that my $50.00 trialing fee will be refunded if I am unsuccessful in being placed in a team. If I change my mind I understand that all monies paid will be forfeited. Signed __________________________________ A parent or carer must sign this nomination form, if the player is 15 or younger as at the 31St December 2008.