PLAYERS APPLICATION FORM
2017 RUBIES NETBALL TEAM
for athletes with an Intellectual Disability.
Netballers must be female, over 16 years of age and have an Intellectual Disability.
Players must have completed the Sport Inclusion Australia eligibility application process.
MARIE LITTLE OAM SHIELD | Perth WA
Friday 1 September – Sunday 3 September
CLOSING DATE: 5pm Friday 21 April
NAME: ___________________________________________________________________________________
ADDRESS: ________________________________________________________________________________
_______________________________________________POST CODE: _______________________________
TEL: __________________________________________ DOB: _____________________________________
EMAIL: __________________________________________________________________________________
CLUB: ________________________________________ ASSOCIATION:
GRADE: ______________________________________ PLAYING POSITION: FIRST
SECOND
PLAYING EXPERIENCE:
HAVE YOU COMPLETED YOUR INCLUSION SPORT AUSTRALIA ELIGIBILITY APPLICATION FORM: YES / NO (PLEASE
CIRCLE)
ARE YOU CURRENTLY A REGISTERED MEMBER OF NETBALL SA: YES / NO (PLEASE CIRCLE)
Applicant’s signature: _____________________________________________ Date:
______
Parent/Guardians Signature: _______________________________________ Date:
______
Please return to:
Nathan Pepper
Inclusive Sport SA Sport and Recreation Coordinator
p. PO Box 63, Torrensville SA 5031
e. [email protected]
Please Note: Acceptance to trial is automatic on receipt of this form unless otherwise notified. Late applications
will not be accepted. Please not that all players selected in the team will be required to undergo fitness testing
with a certain level of achievement expected.
SELECTION DETAILS
Thursday, 4 May 2017
5pm – 7pm
Sunday, 21 May 2017
10am – 12pm
Priceline Stadium
155 Railway Terrace, Mile End SA 5031
If a player is injured and unable to trial, please notify the Inclusive Sport SA office on 08 8122 6730 during office
hours (9.00am – 5.00pm, Monday – Friday).
TRAINING DETAILS
Squad players will be required to attend all training sessions in the lead up to the 2017 Marie Little OAM Shield.
Trainings will be held on Thursday nights, fortnightly from 6.30pm – 7.30pm beginning Thursday, 25 May 2017.
Squad players will be required to attend the Nine News Netball Cup One Netball Disability Round on Friday, 14
August 2017 from 5.30pm – 7.30pm.
If you are unable to attend a training session, the Team Manager is to be notified by 12.00pm on the day of
training.
I am aware of the responsibilities associated with the selection process and I agree to all of the following
conditions:
Players will be required to provide their own drinks for the trials/trainings. Players are also required to attend to
their own medical needs i.e. strapping, managing asthma etc.
10 (ten) players will be selected for the final team, a further 4 (four) players will be chosen to attend selected team
training but will not travel for the competition.
Squad members may be required to carry out a home training program.
The Marie Little OAM Shield will be held on Friday, 1 September – Sunday, 3 September 2017 at Netball Central,
Perth. Players will be required to travel to the competition on Thursday, 31 August and Sunday, 3 September 2017.
Players will be invoiced $XXX.00 to assist in costs associated with the Rubies Netball Team and the Marie Little OAM
Shield. (Amount to be confirmed)
Applicant’s signature: _____________________________________________ Date:
______
Parent/Guardians Signature: _______________________________________ Date:
______