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BWHA - 2027 U16 Representative Player Nomination

Sun 13 Jun 2027 06:30 - Sun 11 Jul 2027 11:30
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Brisbane Women's Hockey Association, 16 Melbourne Street, Windsor QLD 4030

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Basic details

First name*

Last name*

Phone number*

Email address*

Address*

Additional information

Players First Name*

Players Surname*

Date of Birth*

Mobile Number*

Primary Email Address*

Second Email Address

Do you require all correspondence to be sent to a second email address?*

Parent/Guardian Name 1 (18+ type N/A)*

Parent/Guardian Name 2

Club*

If you are unsure which division your child will be playing in, please select the division they will be trialling for at the club. Once nominations close, club secretaries will be contacted by email to confirm or update each player’s trial division.

What Division you are registered in? (this is your primary team that you play your most hockey with)*

Do you play in any other Division? (I.e. subsitute/fill in)*

Club Playing Shirt Number*

Preferred Playing Position*

Secondary Playing Position*

Did you play Representative Hockey in 2026?*

If yes, please list any Representative Teams in 2026 Max 255 characters

Do you have any current injuries/medical concerns? Max 255 characters

Are you unavailable for any trial/training/tournament dates? (please list reason(s) why)

Do you consent to be photographed and/or videoed at Southern Cross & State Championships?*

Please note

All prices are inclusive of GST.
A Booking fee of $65.00 applies for this event.

Terms Of Registration

I acknowledge that I have read and understood the following document: HA Code of Conduct.

Players must be a Full-Time Primary Registered BWHA Member to nominate for a Brisbane Representative Team

Please also be reminded that there should not be photography or videos taken of other participants to protect their privary and consent of being captured - this includes others being in the background of a shot of our child. Any photography or video needs to be solo, and not at the disruption of the groups' overall activities (i.e., before or after the session).

A parent or guardian is required to stay and be in attendance for the full duration of each trial session. Participants may not be dropped off and left alone.

I confirm that I have read the above Terms Of Registration in its entirety.*

I agree to the Terms Of Registration.*

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

Details

Basic details

Additional information

If you are unsure which division your child will be playing in, please select the division they will be trialling for at the club. Once nominations close, club secretaries will be contacted by email to confirm or update each player’s trial division.

Terms Of Registration

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