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Sunday Skippers - Skipping Australia Athlete Membership Form 2022
Welcome to the 2022 Skipping Australia Membership Form. Full details, eligibility and benefits of being a Skipping Australia Member can be found
https://docs.google.com/document/d/1a8sbW0TwiY_mSNVGrOb4iIwMv2bX2kPOftp65qPQTxE/edit?usp=sharing
Skipping Australia will collect membership fees via your club
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* Indicates required question
Athlete First Name
*
Your answer
Athlete Preferred Name
Your answer
Athlete Surname
*
Your answer
Athlete Date of Birth
*
MM
/
DD
/
YYYY
Athlete Gender
*
Male
Female
Indeterminate/Intersex/Unspecified
Athlete home address including suburb, state and postcode
*
Your answer
Athlete contact phone number
*
Your answer
Athlete contact email address
*
Your answer
Emergency Contact - Name
*
Your answer
Emergency Contact - Phone Number
*
Your answer
Relationship to athlete
*
Your answer
If the athlete is under 18, please provide full name of Parent/Carer (If the same as the emergency contact details above, enter 'as above')
Your answer
Parent/Carer contact number (If the same as the emergency contact details above, enter 'as above')
Your answer
Does the athlete have any medical conditions that Skipping Australia or your club need to be aware of?
*
Your answer
Do you give permission for any photos or videos of the athlete to be used by your club, state/territory skipping association or Skipping Australia to be used for promotional purposes?
*
Yes
No
Athletes Classification
*
Choose
Competitive Athlete
Recreational Skipper
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