STATE TEAMS - Hockey NSW Non-Selection Form

THIS NON-SELECTION FORM MUST BE SUBMITTED AT LEAST 24 HOURS PRIOR TO THE FIRST GAME AT THE RESPECTIVE STATE CHAMPIONSHIPS. COMPLETING THIS FORM DOES NOT MAKE YOU ELIGIBLE TO PLAY OR TRIAL FOR ANOTHER STATE/TERRITORY. YOU WILL BE REQUIRED TO GAIN A CLEARANCE FROM HOCKEY NSW IF YOU WISH TO PLAY OR TRIAL FOR ANOTHER STATE/TERRITORY.

PERSONAL INFORMATION

Full Name*

Email Address*

Mobile Number*

Primary Association*

Association that you will represent at State Championships?*

Field or Indoor?*

Which State Team are you are seeking an Non-Selection From?*

Name of Applicant or Parent/Guardian if applicant is under 18 years of age.*