Form B
Southland Wide Club Competition Game Change Request
Game Change Request form allows you to request a change to your fixtures in the Southland Wide Competition as per
the Southland Wide rugby club competition rule 11.3. Games can be rescheduled by mutual consent between the clubs
involved provided Rugby Southland is notified minimum 7 days prior to the game and the Community Operations
Manager consents to the change after consultation. This will be followed up with an Email to confirm the outcome of
your request.
It is the home teams responsibility to notify the referee.
Person Requesting Change:
First Name:…………………………………………………………………………………………….
Last Name:…………………………………………………………………………………………….
Email:…………………………………………………………………………………………….
Phone:…………………………………………………………………………………………….
Original Fixture Details:
Grade:…………………………………………………………………………………………….
Team vs Team:…………………………………………………………………………………………….
Original Venue:…………………………………………………………………………………………….
Original Date:…………………………………………………………………………………………….
Original Time:…………………………………………………………………………………………….
Requested Fixture Details:
Amended Venue:…………………………………………………………………………………………….
Amended Date:…………………………………………………………………………………………….
Amended Time:…………………………………………………………………………………………….
Opposition Team Contact who agreed to change:
Name:………………………………………………………………………………………
Email:…………………………………………………………………………………………….
Phone:……………………………………………………………………………………………
Signed
………………………………………………..
Terms and conditions:
The change is not finalized until Rugby Southland have approved the request.
To complete online (electronically) go to Sporty Web-site www.sporty.co.nz/southlandrugby and click on the “Game
Changes Tab”