This compulsory registration process is only for those players who have been chosen to represent their zone at Diocesan Primary AFL Trials held at Grafton (Lower Fisher Park) on 23 February 2018. The player profile section of this form will be used mainly to enable convener and selectors to place each participant so that they can best showcase their skills.

Students/parents are to bring the $15 levy and pay it to the convener on the day.

Trial Time 9.30am - 2.30pm (approx)

Please complete this form by no later than 13 February 2018.

Please complete all questions or type N/A where not applicable.

Players First Name *
Your answer
Players Surname *
Your answer
Date of Birth *
Please ensure you write the year of your child's birth, not "2018"
Students Age in 2018 *
Note: this is the age they will be turning in 2018
Your answer
Zone *
School *
Schools are listed alphabetically according to town
Medicare Number *
Your answer
Health Fund Name *
Your answer
Health Fund Number *
Your answer
Medical Information *
Please note here any medical/health information of which managers should be made aware of e.g. allergies, dietary restrictions, medication, puffer, epipen etc. Please type N/A if none.
Your answer
Parent First Name *
Your answer
Parent Surname *
Your answer
Parent Home Phone Number *
Your answer
Parent Mobile Number *
Your answer
Parent Email Address *
Your answer
Preferred Playing Position 1 *
Your answer
Preferred Playing Position 2 *
Your answer
Preferred Playing Position 3 *
Your answer
Playing Achievements/Experience *
Please outline your child's AFL playing achievements and experiences including representative record. Include anything you believe selectors should consider BUT please be as brief as possible and use point form rather than sentences
Your answer
Polding Trial Availability *
Please click Yes to indicate your child is available for Polding Trials at Newcastle on 4 April 2018 if selected on 23 February 2018. If no please withdraw your child from the Diocesan Trial and DO NOT COMPLETE THIS FORM.
Levy Payment *
Please click Yes to indicate that you are aware that the $15 levy for the Diocesan Trial is to be paid to the convener on the day (no credit card facilities will be available).
Codes of Conduct *
Click Yes if player and parents have read and will abide by their respective codes of conduct at these trials and that you understand and accept that your child is to behave in an appropriate manner and you have explained this obligation to your child. Clicking Yes also indicates that you are aware that if your child seriously contravenes behavioural expectations, they may be immediately excluded from the trial. Should this eventuate, you accept full responsibility for your child upon notification of their exclusion by the convener, Yes also indicates that you are aware that the child's school may take disciplinary action after this event and that future Diocesan sports representation may be in jeopardy.
Consent *
I hereby consent to my child participating in Diocesan Primary AFL Trials, I understand that transport to and from the venue and accommodation is a parent/guardian responsibility, In the event of accident or illness I authorise the obtaining on my behalf of any such medical assistance that may benefit my child, I accept responsibility and expenses incurred. Please note that your child's school and or/zone might also require written consent for this activity.
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