2019 Oceania Player application form
Use this form to apply to trial for the 2019 Oceania Championships

Please read through this section carefully before filling in all sections of the form.

The closing date for applications is the 31st October 2018 at 6pm

Payment of a $100 application fee is required. NZCPA Squad account: 02 0876 0048375 002

The primary method of communication will be via a Facebook closed groups for the appropriate squads.
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Information may also be shared by email and through our website: www.nzcanoepolo.org.nz

It will be your responsibility to check for information and keep yourself up to speed with the information shared.

PARENTS, please contact me directly if you are able to help out with the organisation and/or running of the camps. Many hands make light work and will also help us deliver a successful campaign.

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

Email address *
First Name/Names *
Your answer
Surname Name *
Your answer
Gender *
Squad applying for (you may apply for multiple) *
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 002. This must be paid at the time of applying. Please reference the payment with the players name and development. *
Are you over 18 years old? *
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