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APPLICATION FOR PROOF OF AGE REGISTRATION

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					                    APPLICATION FOR PROOF OF AGE REGISTRATION
INSTRUCTIONS TO SKATER
 R g t t n se i d o s b s E I IIIY o cm et n hm i si i g r r t n.
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• eir i ir u e t et lh LG BLT fro pti / a p nh wt ae etcossii
 LF TME e sao se gi dh uhu A saa
        g ttn c z r           ri
• IE I r ir i ir on e t ogot ut l.
 C m le plao sould be forwarded to ISA via your home State Association.
     ed i i
• o p t ap ct n h


                                     NSWISA - PO Box 3266 North Strathfield 2137
 N e sao e s aal
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• Or ir i f ipyb .
 P A u brss e a so a pa i b f re i o a A I P LC TO .
          s           cc e t c p
• O nm eii ud son s r tala er e tf V LDA P IA I N
 U D T f O eie ss e
               sr s
• P A Eo P AR g t ii ud to State Secretaries at regular intervals.

INSTRUCTIONS TO OFFICIALS
BOTH parts of application must be completed CLEARLY and IN FULL:
(1) Name of Official                                                         (2) Status of Official
(3) Name of Club or State Association                                        (4) Description of Evidence e.g. Birth Cert/Passport
(5) Full Name of Skater (Block letters)                                      (6) Date of Birth (clear figures)
             Take care with SPELLING OF NAMES.
             Any alterations must be initialed.
             A y lbSa o N t n l fc l orl e t sa r rkt ’cah y ety
                       t     i
               n Cu , t e r a o a O f i n te t o kt o sa r oc ma crf
                                    ia      ad    e     es         i.


PART 1

I (1) ............................................................................................................. BEING (2) .................................................................

OF THE (3) ................................................................................................. HAVE SIGHTED THE (4)........................................

OF (5) .......................................................................................................... AND CONFIRM THAT THE DATE OF BIRTH

SHOWN THEREON IS (6) ........................................................................ .

I AM NOT RELATED TO THE SKATER NAMED, OR TO HIS/HER COACH.

SIGNATURE OF PERSON SIGHTING.....................................................

PART 2

I (1) .............................................................................................................. BEING (2) ................................................................

OF THE (3) ................................................................................................. HAVE SIGHTED THE (4)........................................

OF (5) .......................................................................................................... AND CONFIRM THAT THE DATE OF

BIRTH SHOWN THEREON IS (6) ............................................................ .


I AM NOT RELATED TO THE SKATER NAMED, OR TO HIS/HER COACH.
SIGNATURE OF PERSON SIGHTING.....................................................

				
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Description: APPLICATION FOR PROOF OF AGE REGISTRATION