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National Team Declaration Form 2023
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* Indicates required question
Do you consent to being contacted in relation to the information you have provided for the purposes of representing Ireland by the Athletics Ireland High Performance Team. Your information will be held for one year for the purposes as given. This database will then be destroyed as per our GDPR policy.
Yes
No
Clear selection
Full Name
*
Your answer
Full Name as per Passport
*
Your answer
Mobile number (if Under18 please add parent or guardian instead)
Your answer
Email
*
Your answer
Parent/Guardian Email (only if U18)
Your answer
Club
*
Your answer
What is your vaccination status?
Choose
Double shot fully vaccinated (Pfizer, Moderna, Astra Zeneca, etc.)
Single shot fully vaccinated (Johnson & Johnson/Janssen)
Fully vaccinated with booster shot
Received one shot of two shot dose
Not vaccinated
Coach Name
*
Your answer
Coach Phone Number
*
Your answer
Coach Email Address
*
Your answer
Gender
*
Female
Male
Date of Birth
*
MM
/
DD
/
YYYY
Nationality
*
Your answer
Do you have a current Irish passport?
*
Yes
No
Other:
Passport No
*
Your answer
Passport Country of Issue
*
Your answer
Passport Expiry Date
*
MM
/
DD
/
YYYY
Are you currently eligible to represent Ireland?
*
Yes
No
Other:
Events
Please indicate which Championships you are submitting a declaration of interest to compete.
European Cross Country Championships 2022
Yes
International development Cross World athletics Tour
CrossCup de Hannut
2023 (Hannut, Belgium, 22nd Jan)
Yes
World Cross Country Championships 2023 (Bathurst, Australia, 18th February)
Yes
European Indoor Championships 2023 (Istanbul, Turkey, 2nd to 5th March)
Yes
Dynamic New Athletics U20 Indoor Event 2023 (Madrid, Spain, 22nd February)
Yes
European Throwing Cup 2023 (Leiria, Portugal, 11th to 12th March)
Yes
European Race Walking Cup 2023 (Podebrady, Czech Republic, 21st May)
Yes
European 10,000 Cup 2023 (Pacé, France, 3rd June)
Yes
European Team Championships 2023 (Silesia, Poland, 20th to 25th June)
Yes
European U20 Championships 2023 (Jerusalem, Israel 7th to 10th August)
Yes
European U23 Championships 2023 (Espoo, Finland, 13th to 16th July)
Yes
European Youth Olympic Festival 2023 (Maribor, Slovenia, 23rd to 29th July)
Yes
World Championships 2023 (Budapest, Hungary, 19th to 27th August)
Yes
World Road Running Championships 2023 (Riga, Latvia 30th September to 1st October)
Yes
European Cross Country Championships 2023
Yes
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