Pathway Program - Candidate Entry Request
14th May 2022 - Spartan Judo Club, 12.30pm to 2.00pm.
YMCA Community Centre, 80 Jervies Street, Portadown.

Coaches, please use this form to submit the information of the player that you request to attend the Pathway Squad Training Sessions.

Closing date for applications for this event, is 12.00pm 12th May 2022.

This is for players aged between 12 and 17 years old.

Please note the minimum grading requirements (9th mon or above), and the standards expected for the Judoka to attend the sessions including regular club training attendance.

Please also note that continued attendance at Pathway Squad sessions remains at the discretion of the Pathway Squad Coaching Team and the Program Director.

The mat fee of £6 per player must be paid on the day.

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Players First Name *
Players Surname *
Gender of Player
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Age of Player
Emergency Contact Full Name and Contact Number *
Club of Player *
NIJF Licence Number (please note, only NIJF licenced players can participate) *
Does the player have any allergies or medical conditions we need to be aware of? *
If you answered yes above, please list what we need to be aware of (or complete with N/A). *
Declaration
As coach of my club, I have the authority to recommend this player for the Pathway Squad initiative. I am fully aware of the standards and requirements that this involves and the level of the input required from myself.
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Electronic Signature in here (type full name)
Date of submission
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