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ATHLETE INFORMATION
Full Name (as shown on I.D)**
Date of Birth**
Best Contact Number**
Best Contact Email*
Current Postcode*
Frequent Flyer Number (QANTAS or Virgin)
CONTRACT INFORMATION
What Hockey NSW State Team have you been selected for?*
Please select...
O34s
O40s
O45s
O50s
O55s
O60s
O65s/O70s Combined
If you have been apart of a Hockey NSW Women's Masters team in the past, please state your playing number used.*
In the case of your previous Playing Number being taken, what is your 2nd & 3rd preferences?*
In the case of your previous Playing Number being taken, what is your playing singlet/shirt size?*
In the case of your previous Playing Number being taken, what do you prefer?*
POLICIES
I understand that the National Championship/Tournament will be played under the rules as set by Hockey Australia. I also understand that Hockey is a limited contact sport and there is a risk of injury involved in playing Hockey. I authorise any Official in charge of the National Championship/Tournament or NSW Team, in the event of illness or injury, to obtain on my behalf and at my expense any medical assistance, treatment and transportation as deemed necessary, Indemnity: Except where provided or required by law and such can not be excluded, I agree that Hockey NSW and its respective directors, officers, members, servants and agents are absolved from all liability arising from injury or damage to me, however caused, whilst participating in the National Championship/Tournament competition.I have read, understood and agree to the above terms. I warrant that all information provided is true and correct.*
Please select...
Yes
As a Hockey NSW Player, I declare that I have read and understood the following documents as sent to me via email from Hockey NSW and I accept the terms contained therein. 1. Player Contract and Indemnity - Attachment 1 - Mouthguard Policy - 1A - Mouthguard Waiver, 2 - Attachment 2 Hockey Australia Code of Conduct - Attachment 3 - Injury and Fitness Agreement.*
Please select...
Yes
Full name of Player declaring acceptance of the 2023 Hockey NSW State Player Contract as sent via email from Hockey NSW.*
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