STATE TEAMS - Hockey NSW Clearance Form

THIS CLEARANCE 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 YET, HOCKEY NSW MUST APPROVE THIS CLEARANCE BEFORE YOU CAN DO SO AND THIS WILL BE CONFIRMED VIA EMAIL.

PERSONAL INFORMATION

Full Name*

Email Address*

Mobile Number*

Primary Association*

Field or Indoor?*

What age group are you wanting a clearance for?*

State or Territory you wish to be released too?*

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