Details

2024 Player Exemption Request Form

Tue 30 Jan 2024 18:45 — Tue 31 Dec 2024 23:45

Form

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Are you attending this event?

Yes No

Basic details

First name*

Last name*

Phone number*

Email address*

Address*

Additional information

Name of player*

Details/Reasons for exemption* Max. 255 characters

Competition type*

Competition gender*

Competition age group*

Association*

QLD Squad/Team*

I declare that I am applying for an Exemption and I am eligible for state selection for the above mentioned Queensland Team/Squad*

Yes

I have read and accept the eligibility for selection disclaimer above.*

Yes

Medical Certificate/Supporting Evidence

Choose file...

Max 5MB

Event Waiver

National Registration Terms for Events 2024

Thank you for completing the Player Exemption Form

I understand that applications for Exemption from a Hockey Queensland Tournament will not be accepted if ALL information is not completed and submitted prior to the commencement of the event.

I understand that Exemption Requests can be submitted up until 2 days prior to respective championships or trials commencement.

I acknowledge that Applications for Exemptions submitted after the closing date will not be accepted. If seeking exemption on medical/injury grounds, I understand that I must provide a medical certificate to Hockey Queensland before the closing date for applications or my application will be deemed incomplete.

All information provided in this Application for Exemption is true and accurate and I understand that approval for Exemption is at the discretion of Hockey Queensland.

I confirm that I have read the above Event Waiver in its entirety.*

I agree to the Event Waiver.*

I am over 18, or, if I am under 18, this registration has been filled out by and endorsed by my parent or guardian.*