NZ Representative Self-Nomination
Self-nomination to be considered as a contender for selection to a New Zealand National Curling Team.
Full name
Your answer
Preferred name
Your answer
Email address
Your answer
Phone number(s)
Please include area code for a landline
Your answer
Address
Please include postcode
Your answer
Date of Birth
MM
/
DD
/
YYYY
Gender
Nationality
If a NZ resident - for how many years?
Your answer
What is your home (local) club?
Your answer
Number of years Curling experience
Note: beginner curlers are unlikely to be considered
Your answer
Preferred playing position
Please select one only
Other positions I would play
Team(s) I would like to be considered for
Please rank teams in order of preference - but you do NOT need to list all preferences (e.g. if you only wish to be considered for one team, just mark that as your 1st preference and leave others blank)
NZ U21
NZ Open (PACCs)
NZ Mixed Doubles
NZ Mixed Fours
NZ Seniors
1st preference
2nd preference
3rd preference
4th preference
Comments
Your answer
Declaration
1/ If selected for a team, I confirm that I am available to travel to play for that team in national and specified international fixtures during the coming 12 months (July 2017 – June 2018). 2/ I understand that if selected for a team, I will have to enter into an “Athlete Agreement” with the NZCA, and that I am committed to doing so. 3/ I understand that I may be required to register for out of competition random drug testing with Drug Free Sport NZ as well as drug testing at events. 4/ I understand that if selected for a team, I may have to cover some or all of the costs of travelling to train for and/or to play in national and international fixtures. 5/ I agree to abide with and be bound by the decisions of the National Selectors.
Required
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