State Team Nomination Form - Open Male (Patriots) Team
Please carefully read the information below and complete all sections of the form relevant to the team/squad/s you wish to nominate for.

All nominees must:
Be a current registered member of a full member District Softball Association in Queensland;
Submit the fully completed nomination form to the SQI office by the due date
NOTE: Only one nomination per form is required to be submitted.


Pay the nomination fee of $36 by the due date:-
NOTE: Only one nomination fee is required regardless of the number of teams/squads you are nominating for.
NOTE: A late fee of $55.00 will be imposed for nominations submitted or received after the close of business on the closing date. The total cost of the nomination will be $91.00 ($36.00 nomination fee plus $55.00 late fee)
Nominees who are current Australian Open Team members from the last World Championship/Olympic Games or have represented Queensland in the Open Team for the previous five (5) consecutive years are not required to pay the nomination fee.
Please be advised that once the relevant State Team squad has been selected, your nomination fee will be non-refundable

Be age eligible for the team/squad nominating for;
Participate in the 2021 State Championships from which the squad/team they have nominated for is being selected or have an exemption granted by the SQI High Performance Committee
NOTE: Exemptions will only be granted in extenuating circumstances Examples: injury (doctor/physiotherapist report required with full details of injury & rehabilitation program and time frame); on Australian team commitments; on a professional contract in an approved overseas competition

Nominations close Monday 30th August 2021
Email *
Surname *
Given Names *
Address *
Postcode *
Contact Number *
Date of Birth *
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Confirming you are nominating for Open Male (Patriots) *
Which State Championship are you participating in? *
Which District Association are you representing? *
Please indicate your nominated playing position *
Please indicate your second nominated playing positions *
Agreement to terms and conditions of nomination I acknowledge that the SQI Rules, and Policies are available for my information from the SQI website (www.qld.softball.org.au). I have read and understood all information on this nomination form and agree to abide by all SQI Rules, and Policies. I have read and understood all information on this nomination form, including but not limited to: Codes of Conduct, expectations, payment of expenses, and agree to abide by all SQI Rules and Policies. *
Required
Name of Parent/Guardian (if nominee is under 18)
Signature of Parent/Guardian (if nominee is under 18)
Today's Date *
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Is the player nominating for selection an Australian Citizen? *
Do you wish to be considered for the national draft? *
Have represented Queensland at a national championship in the past, if yes please list the year you last represented below
Agreement to capture my image; I give permission for SQI to take and use images of me / my child for promotional and development purposes including all media, brochures, posters, website and marketing collateral for Softball Queensland Inc, Softball Australia Ltd and any relevant Queensland Government Sport and Recreation programs. *
Required
Nomination Fee payable of $36 by the due date. Nomination is not accepted until the fee is received. Nominations received after the due date will incur an additional $55 late fee. *
I have read the player nominations terms and conditions https://drive.google.com/file/d/1kylKMMYvk8qef86SCTkg07z1-T_S4Ro3/view?usp=sharing *
Signature of Approval. I can confirm I am the person lodging this form and agree to the terms and conditions *
Required
A copy of your responses will be emailed to the address you provided.
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