PDSSSC Touch Individual Trial Registration form - 2022 - Wednesday 16th March - Jamison Park

This form is for registration for the revised PDSSSC Touch Individual Trial.
You need to complete this form even if you completed the previous form, clearly stating your Representative playing history in the last 2 years only.
You MUST complete this form to be considered for this Individual Touch PDSSSC Selection trial.
One form is to be completed per child per sport. Please complete the form and then click SUBMIT This form is an EXPRESSION OF INTEREST and MUST be first approved by your child's school in order for them to attend the nominated trial or event, and secondly be chosen by the selectors to attend. Your school Sports Coordinator will confirm your attendance at the event if successful
(*Required field)
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Team you are registering for *
Please select carefully from the following list of Sports or Teams for particular sports
Student's first name *
Student's Surname *
Student's date of birth
Date of birth is to be in dd/mm/yyyy format
Student's School Name and Suburb *
Please select from the following list
Student's Current Year of School *
Please select from the following list
Student's Gender *
Please select from the following list
Parent / Guardian First Name *
Parent / Guardian Surname *
Parent / Guardian Email Address *
Parent / Guardian Mobile Phone Number *
Contact name in case of emergency *
Please list other parent or guardian or another person to contact.
Contact number in case of emergency *
Please list a contact number for the person listed above
Do you have a medical condition and / or medical plan that we should be aware of?? *
Please be specific, in case of a medical crisis or treatment being necessary.
List your Number 1 preferred position for this sport
To help with selections for teams sports, please list your number 1 preferered position.
List your Number 2 preferred position for this sport ( If a team sport)
To help with selections for teams sports, please list your number 2 preferered position.
List your Touch Football Representative playing history over the past 2 years.
Parental Consent *
Please tick the appropriate boxes if you give permission
Required
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