2024 Draft Players - ACT Athlete Forms

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Thu 31 Aug 2023 09:00 — Sun 01 Jun 2025 09:00

Softball ACT, 45 Walhallow Street, Hawker, 2614, ACT

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Basic details

First name*

Last name*

Phone number*

Email address*

Address*

Additional information

Team(s) you have been selected for*

I have read and understood the Code of Conduct for Representative Players and agree to meet the requirements of the code*

If I am under 18 years of age my parent/guardian has read and understood the Code of Conduct for Representative Players and agree to assist me meet the requirements of the code*

I have read and understood the State Player Agreement and agree to meet the requirements of the agreement*

If I am under 18 years of age my parent/guardian has read and understood the Representative Player Agreement and agree to assist me meet the requirements of the agreement*

Date of last tetanus injection*

Heart Problems*

Respiratory Problems*

Allergies* Max. 255 characters

Recent Illness* Max. 255 characters

Drugs/Medication Required?*

Drug Reactions (eg penicillin allergy)?*

Blood Pressure Issues*

Phobias*

Diabetes*

If you have medical action plan (eg Asthma, Anaphalaxis) please upload here0

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Max 5MB

Blood Type* Max. 255 characters

Doctors Name* Max. 255 characters

Doctors Address*

Doctors Phone Number*

Ambulance Cover and Cover Number*

Medicare Number (include your number on the card)*

Please note

All prices are inclusive of GST.
A Booking fee of $500.00 applies for this event.

I am over 18, or, if I am under 18, this registration has been filled out by and endorsed by my parent or guardian.*

2024 Draft Players - ACT Athlete Forms

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Basic details

Additional information

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