CENTRAL COAST CENTURIONS MAJOR SPONSOR REPRESENTATIVE PROGRAM U/15 COUNTRY CHAMPIONSHIP SQUAD SELECTION TRIAL SUNDAY 29th MARCH 2015 MINGARA SPORTS COMPLEX TO BE CONSIDERED YOU ARE REQUIRED TO REGISTER THIS REQUEST TO TRIAL FORM PRIOR TO 5.00pm WEDNESDAY 25th MARCH 2015 UNSUCCESSFUL APPLICANTS SHALL BE ADVISED VIA EMAIL PRIOR TO 12noon FRIDAY 27th MARCH REGISTRATION 10.30am – 11.00am TRIAL COMMENCES AT 12.00noon NAME: ………………………………………..…. CLUB/ TEAM 2015: ………………..…….………………… ADDRESS: .............................................................................................................................................. D.O.B: ……/……/2000. EMAIL: ……………………………………..…. PHONE: ……….………………… PREFFERED PLAYING POSITION/S: ............................................................................................ SHORTS SIZE: ……………….. SHIRT SIZE: ……………….. (a) Successful applicants are required to play in the selection trial organised by the Central Coast DJRL each year to be eligible for selection in Central Coast DJRL Representative teams Players may also be selected through Central Coast DJRL competition rounds. (b) A player may seek and be granted exemption from the trials if he is injured or ill but a Doctors Certificate will be required and he must still attend the trial unless his Doctor states in the certificate he is too unwell to do so. (c) A player may seek exemption from the trials on the basis of a family crisis. This must be in writing and a decision on the exemption will be made by the Division President, and the Representative Secretary. (d) A player may seek exemption from the trials and if he is playing a non-conflicting sport on the day. (e) The said player acknowledges that Central Coast DJRL has strongly recommended I undertake personal health insurance with the highest available medical benefits scheme cover. All applications to: Email: PO Box 3496 Tuggerah NSW 2259 Telephone: (02) 4359 7200 Fax: (02) 4355 4570 Email: [email protected] Simone Hugo. Unit 3, 6 Morton Close Tuggerah 2259 [email protected] NO FAXED COPIES PRINCIPAL PARTNERS