Application to attend the NZCPA 2018 U18 pathway to....... development camp
Use this form to apply to join the U

The closing date for applications is 31st August 2017

Please answer all sections.

At this stage we are looking at holding up to 7 training camps / compulsory events for both Mens and Womens Squads, the cost of these camps will be $200.

The first Womens camp will be held in Otaki on the 16th and 17th September.
It is likely that the first Mens camp will be around a similar date.

We are projecting a ball park budget of $8,000 for the tour.
Further details of training camps, details of the tour and budgets will be shared once coaches and managers have been appointed.

Players can look to apply to their clubs for funding to offset some of these costs.

You should read; http://nzcanoepolo.org.nz/wp-content/uploads/2017/08/2018-World-Championships-Campaign-Overview.pdf

You may also wish to make yourself familiar with the various documents which can be found at; nzcanoepolo.org.nz/resources-landing-page/policy-and-guidelines/

The primary method of communication will be via 2 Facebook closed groups;
Paddle Ferns 2018 World Championships
Paddle Blacks 2018 World Championships
Information will also be shared by email and though our website; nzcanoepolo.org.nz
It will be your responsibility to check for information and keep yourself up to speed with the information shared.

Please email the Squads Director at nzcpasquadsdirector@gmail.com if you have any questions

Email address *
Personal Details
Please fill in the details of the person wishing to apply
First Name/Names *
Your answer
Surname Name *
Your answer
Gender *
Email address *
Your answer
Mobile phone *
Your answer
Home phone *
Your answer
Full Postal Address *
Your answer
Date of Birth *
MM
/
DD
/
YYYY
Next of Kin
Please provide details of your next of Kin
Full name *
Your answer
Relationship to Squad Member *
Your answer
Full Postal Address *
Your answer
Home phone number *
Your answer
Work phone number *
Your answer
Mobile phone number *
Your answer
Email address *
Your answer
Medical
Special Dietary Requirements *
Your answer
Medical Conditions / Allergies / Medications *
Your answer
Proof of Membership:
Complete the details of the Club and National League team you play for along with the details of the person within your club who can confirm you are financially affiliated to the New Zealand Canoe Polo Association.

The Squad Manager will also contact this person to confirm you are financially affiliated to the New Zealand Canoe Polo Association as part of the application process.

Canoe Polo Region *
Your answer
Canoe Polo Club *
Your answer
National League Champs Team: *
Your answer
Name (club contact) *
Your answer
Their position within club *
Your answer
Their email address *
Your answer
Their mobile number *
Your answer
I have contacted the person named above who has confirmed I am financially affiliated to the New Zealand Canoe Polo Association. *
Required
Code of Conduct
All players are obliged to follow the following code of conduct;

• Respect the rights, dignity and worth of others.

• Do not engage in any form of abuse, harassment, discrimination, or victimisation towards others.

• Be fair, considerate and honest in all dealings with others.

• Accept responsibility for your actions.

• Be aware of and maintain adhesion to rules, guidelines, and policies.

• Never argue with or verbally abuse an official. Always use the appropriate rules and guidelines to resolve a dispute.

• Do not use obscene language.

• Conduct yourself in a sportsman-like manner and respect fellow players, coaches, managers,
officials, and the achievement of opponents.

• Cooperate with your coach, managers, and team mates.

• Comply with training, competition, curfew, and behaviour requirements directed by New Zealand Canoe Polo while in camp and on tour.

• Do not engage in sexual behaviour while in camp or on tour.

• Do not possess or consume prohibited substances while in camp and on tour.

• Do not consume or purchase alcohol and tobacco while in camp or on tour without the agreement of the manager and coach.

• Be a positive role model.

• Have respect for New Zealand Canoe Polo property and the property of others.

• Never act in a way that may bring disrepute or disgrace to New Zealand Canoe Polo, its members, stakeholders, and sponsors/potential sponsors.

I have read the code of conduct and agree to uphold it when representing the NZCPA both on and off the water *
Required
Declaration
I consent to the information on this form being used by the New Zealand Canoe Polo Association and its regions to compile mailing lists and other data which may be distributed to competition organisers, funding bodies, sponsors and parent bodies of the New Zealand Canoe Polo Association.
This consent is given in accordance with the Privacy Act 1993.

I agree to abide by all relevant clauses in the Selection and Squad Guidelines. I understand that I am obliged to pay my share of all Squad costs, and have an understanding of the magnitude of those costs.

A non-refundable application fee of $100 must be paid into the Squad Account; 02 0876 0048375. This must be paid at the time of applying. Please reference the payment with your name and squad. *
Are you over 18 years old? *
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