ECU Sports - Team Sports Nomination Page 1 of 2 As at Nov 2014 Issue 6

ECU Sports – Team Sports Nomination Form SECTION 1: TEAM NAME AND CONTACT DETAILS

PROPOSED TEAM NAME:

TEAM COORDINATOR [MUST BE 18 YEARS OR OVER]

FIRST NAME: SURNAME: ARE YOU 18 OR OVER? Yes No

ADDRESS:

SUBURB: POSTCODE:

PHONE (LANDLINE): PHONE (MOBILE):

EMAIL: ECU STUDENT? Yes No

ASSISTANT COORDINATOR [SECOND CONTACT]

FIRST NAME: SURNAME: ARE YOU 18 OR OVER? Yes No

ADDRESS:

SUBURB: POSTCODE:

PHONE (LANDLINE): PHONE (MOBILE):

EMAIL: ECU STUDENT? Yes No

SECTION 2: PLEASE MARK (X) CHOSEN SPORT / CENTRE

Sport / Day ECU Joondalup

ECU Mt Lawley

Requested Division (1/2/3)

To register for other team sports including Touch Football and Basketball visit the link below for more information www.ecu.edu.au/sport/team_sport.php

Mixed Netball / Monday Evenings

Indoor Soccer / Thursday Evenings SECTION 3: HOW DID YOU FIND OUT ABOUT US

Website Facebook Newspaper Notice Boards / Flyers Email Word of Mouth Mail Other (Please specify): ___________________

ECU Sports - Team Sports Nomination Page 2 of 2 As at Nov 2014 Issue 6

SECTION 4: PLAYER REGISTRATION TC = Team Coordinator. AC = Assistant Coordinator. A minimum of 4 phone numbers must be listed (including TC and AC).

First Name Surname Phone Email ECU Student?

TC AC 3. 4. 5. 6. 7. 8. 9.

10.

SECTION 5: TEAM DECLARATION (Person named and signing below must match Team Coordinator details in SECTION 1)

Should nominations exceed the number of team spaces available, preference will be given to teams whose nominations are in before the start of the new competition. The Team Sports Coordinator reserves the right to accept or reject any nomination and to delete any team or players from the competition during the season due to misconduct or forfeits. Games are played on public holidays unless stated on the fixtures. Upon ECU Sports accepting my nomination, I agree our team will pay two (2) game payments on our first night (one for your first game and one for team registration). ECU Sports will then use the team registration payment as a credit for your last game of the season or to pay any outstanding monies owing e.g. team forfeits. You can choose to carry this credit over to the following season if you wish to renew your nomination. As the Team Captain, I agree to communicate with my team to advise them of the Centre’s ‘Conditions of Entry’. Accordingly, on behalf of the team named on this form, I declare that the team will participate in all matches programmed in accordance with the relevant team sports rules and competition guidelines located on the ECU Sports website at www.ecu.edu.au/sport/team_sports for the duration of the season (including final matches) and to honour any fines that may be imposed as a result of this team withdrawing or causing a match to be forfeited or any other fines allocated by the Team Sports Coordinator. Team Coordinator (Print name): _________________________________ Date: ___________________________

Team Coordinator (Signature): ________________________________ CONTACT DETAILS All completed Team Sports Nomination Forms can be emailed to ecusports@ecu.edu.au ECU Sports – Joondalup (08) 6304 5000 ECU Sports – Mt Lawley (08) 9370 6700 Please visit our website for full contact details: www.ecu.edu.au/sport/location

OFFICE USE ONLY

Date received:

Receiving staff member:

Entered in Contacts List by:

Social Team Sports Season: