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Zones/State Championship Qualifiers Host Centre Expression of Interest
Please use this form to express your Centre's interest in hosting the 2022 Zones/State Championships Qualifiers event in either Zone 1 or Zone 2.
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Zone
*
Choose
Zone 1: Baldivis, Belmont, Cockburn, Dale, Gosnells, Kwinana, Melville, Peel, Rockingham, Southern Districts
Zone 2: Bayswater, Eastern Hills, Hamersley, Inglewood, Joondalup, Kingsway, Ridgewood, Swan Valley, UWA
Centre Name:
*
Your answer
Centre Contact Name:
*
Your answer
Centre Contact Number:
*
Your answer
Centre Contact Email:
*
Your answer
Competition Venue
*
Your answer
Competition Venue Owner/Manager (e.g. Council)
Your answer
Is the venue available to host competition on the 12-13 February?
*
Yes
No
Other:
What faciliaties are available at the venue (please check all that apply):
*
Kiosk/Canteen
8 Lane Circular Track
8 Lane Short Track (separate to circular track)
Toilet Facilities (please list how many in additional information)
Parking (please detail in additional information)
Other:
Required
Any other information you think we need to know:
Your answer
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