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2024 Borneo Cup Girls

This registration form is for players invited to participate in the 2024 Borneo Cup. Please complete all fields to confirm acceptance of your invitation.

Player details

Please enter the player’s details below, as it appears on their passport.

Full Name (As per your passport)(Required)

First Middle Last

Date of Birth(Required)

DD slash MM slash YYYY

Which Age Group have you been selected in?(Required)

Playing Position – First Choice(Required)

Playing Position – Second Choice(Required)

Parent/Guardian details

Please enter details of parent or guardian responsible for participant.

Parent/Guardian – Name(Required)

Prefix First Last

Parent/Guardian – Email(Required)

Parent/Guardian – Mobile(Required)

Participant – Medical information

Please provide details or any relevant medical or dietary information.

Does the player suffer from any of the following medical conditions?(Required)

No – The player does not suffer from any medical conditions

Respiratory Problems

Diabetes

Headache/Migraines

Skin Problems

High Blood Pressure

Epilepsy

Eye/Ear problem

Emotional Illness

Asthma/Bronchitis

Allergies (mild – severe)

Digestive Disorder

Other (specify below)

Please specify medical details(Required)

Medicare number(Required)

Do you have private health cover?(Required)

Yes

Private health – Provider name(Required)

Private health – Member number(Required)

Will the player require regular medication during the tour?(Required)

Yes

Please specify details of medication(Required)

Date of last tetanus vaccination (if known)

YYYY

Does the player have any special dietary requirements?(Required)

Yes

Dietary Requirements(Required)

List N/A if not applicable

Please include any extra medical or dietary information that may be of assistance

Apparel

On payment of your deposit, you will be forwarded a link to send us sizing for playing and off field kit.

Code of conduct(Required)

I agree to the Football West Junior Touring Team Code of Conduct

Consent(Required)

I hereby confirm that all information provided above is true and correct and give my consent for the player named above to attend the 2024 Borneo Cup and for Football West to seek and authorise medical or other assistance as may be required.