TEAM ENTRY FORM - BOYS
2017 NATIONAL AGED CLUB CHAMPIONSHIPS FOR BOYS AGED 18 YEARS AND UNDER –
BORN 1999, 2000 and 2001
NOTE ONLY PLAYERS BORN IN THE YEARS 1999, 2000 and 2001 ARE
ELIGIBLE TO ENTER THE CHAMPIONSHIPS - THERE ARE NO EXCEPTIONS
TO THIS RULE
COMPETITION POOL:
HBF STADIUM, STEPHENSON AVENUE, MOUNT CLAREMONT, PERTH, WA
DATES OF COMPETITION:
800AM WEDNESDAY 12TH APRIL 2017 TO 200PM MONDAY 17TH APRIL 2017
COMPULSORY COACH THINK ACT PLAY MEETING:
600PM TUESDAY 11TH APRIL 2017 – ROYAL LIFE SAVING BUILDING, MCGILLIVRAY ROAD,
MOUNT CLAREMONT, WA – BACK OF HBF STADIUM NEXT TO WATER POLO WA OFFICES.
IMPORTANT NOTICE TO ALL CLUBS ENTERING NATIONAL AGED CLUB
CHAMPIONSHIPS. PLEASE READ CAREFULLY.
1. All Clubs must be current financial members of good standing with their relevant State Water
Polo Organisation (SWPO) and must maintain that status to be able to compete in a National
Aged Club Championships. If you have any doubt re your clubs financial standing please
speak directly to your State Water Polo Organisation
.
2. All clubs must have no outstanding debts with Water Polo Australia (WPA) – if there are
outstanding debts they must be settled with WPA prior to a team entry being accepted.
3. This entry form must be signed by a member of the Committee/Board of the relevant club.
4. The entry form must also be signed by the relevant State Water Polo organisation and as such
entry forms should be sent to that organisation who will forward them to WPA. Entries received
by WPA that do not have the relevant State Water Polo organisation signature will not be
accepted.
5. Entries Open Monday 9TH January 2017 and close on Friday 27th January 2017 – LATE
ENTRIES WILL NOT BE ACCEPTED.
6. The team entry fee is $1,870 incl. GST and must be paid by Friday 3rd March 2017 – i.e.
payment must be received by WPA by the due date. Failure to meet this payment date
2017 NATIONAL AGED CLUB CHAMPIONSHIPS FOR BOYS AGED 18 YEARS AND UNDER
BORN 1999, 2000 AND 2001 – TEAM ENTRY FORM
PAGE 1
will result in the team being withdrawn from the competition. Invoices will be sent to
each club in the week ending Friday 3rd February 2017. Withdrawal after payment of the
entry fee will result in forfeiture of the entry fee.
7. Player and team eligibility criteria is available on the Water Polo Australia web site.
8. Team List forms, a notice re Draft procedures and player availability, including draft
forms for players and teams, will be available on the WPA web site on Monday 30 th
January 2017. Team lists will be required by Monday 6th March 2017. Draft form
submissions will close on Monday 6th March 2017. The draft will be held on Sunday 12th
March 2017.
9. All coaches and team officials must possess a current Child Protection clearance (Working with
Children Check) – if you are not sure about this qualification contact your local State Water
Polo organisation who will direct you to the relevant State Department. Coaches and team
officials who do not possess this clearance and cannot produce the relevant documentation
(usually a card) will not be permitted to participate in the competition.
10. All participants must be registered on Sports TG with the team names to be submitted via
SportsTG – instructions will be provided to teams by WPA. Teams who do not submit names
via FSP will be excluded from the competition. Teams names, including cap numbers, must be
submitted via SportsTG by Sunday 19th March 2017.
TEAM ENTRY DETAILS – COMPLETE ALL SECTIONS
CLUB NAME
TEAM NAME
IS THIS A
COMPOSITE TEAM
YES / NO
TEAM MANAGER
NAME
TEAM MANAGER
MOBILE NUMBER
TEAM MANAGER
EMAIL
NAME OF CLUB
OFFICIAL
NOMINATING THE
TEAM
2017 NATIONAL AGED CLUB CHAMPIONSHIPS FOR BOYS AGED 18 YEARS AND UNDER
BORN 1999, 2000 AND 2001 – TEAM ENTRY FORM
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CONTACT DETAILS
OF CLUB OFFICIAL
NOMINATIING TEAM
– MOBILE PHONE
NO AND/OR EMAIL
POSITION
SIGNATURE
NAME AND EMAIL
ADDRESS OF THE
PERSON THAT IS
RESPONSIBLE FOR
INVOICES TO BE
SENT TO
DATE
STATE WATER POLO ORGANISATION ENDORSEMENT
NAME OF STATE
WATER POLO
ORGANISATION
NAME OF PERSON
ENDORSING TEAM
POSITION
SIGNATURE
DATE
THIS ENTRY FORM MUST BE SUBMITTED TO THE RELEVANT STATE
WATER POLO ORGANISATION BY CLOSE OF BUSINESS ON FRIDAY
27TH JANUARY 2017. THE RELEVANT SWPO WILL FORWARD THE
ENTRIES TO WATER POLO AUSTRALIA’S MANAGER, EVENTS AND
COMPETITIONS BEFORE COB WEDNESDAY 1ST FEBRUARY 2017
Late entries will not be accepted.
2017 NATIONAL AGED CLUB CHAMPIONSHIPS FOR BOYS AGED 18 YEARS AND UNDER
BORN 1999, 2000 AND 2001 – TEAM ENTRY FORM
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