NSW State Academy Registration Form
Please complete and submit this registration form by the completion of your first State Academy Camp. The first section is for all contact information for the athlete applying. There is a section for parents/guardians further down. Please ensure you update the Head Coach if any details change.
Athlete Name *
First and last name
Your answer
Date of Birth *
MM
/
DD
/
YYYY
Age Group at AJC this year *
Athlete Email
Your answer
Athlete address *
Your answer
Athlete mobile number *
Your answer
Preferred contact method/s *
Required
Club/s *
Your answer
Coach/es *
Your answer
Injuries/Illnesses last 12 months *
Your answer
Any allergies, learning, spatial or physical difficulties? Please provide details. *
Your answer
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