Team Vic 10 - 12 Years Track & Field Expression of Interest Form

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The team selections for the 10-12 Years Vic Track & Field Team will be based on the performance and availability of the athletes. This is an expression of interest form and is in no way a guarantee for selection. In simple terms we need to know if your child is available.

Student's First Name *

Student's Last Name *

School Name *

Home Address

Age as at 31/12/2018 *

Please note that the child must be 10, 11 or 12 to be age eligible.

Date of Birth *

YYYY

The student is ... *

Able body

Multi Class (Please give short description in "other")

Other:

Required

PARENT / GUARDIAN # 1

Full Name *

Mobile Number *

Email *

PARENT / GUARDIAN # 2

Full Name

Mobile Number

AVAILABILITY

The Student is... *

The selectors need to know if the student is available, prior to selections taking place.

Available for selection

Not available for selection

The student's parents are not at the championships (the parents will be contacted via the details given)

I understand that if the student is to be selected in the Team Vic Track & Field Team, his/her parents must confirm their place in the team via the online registration that includes a $500 deposit by Thursday 2 November 2017. *

The online registration will accompany the team announcement on the SSV website www.teamvic.info

I understand

I will inform the parents / guardians.

Submit

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