2025 Borneo Cup

2025 Borneo Invitational Sizing and Player Information

Player Name(Required)

First Last

Date of Birth(Required)

MM slash DD slash YYYY

Age Group(Required)

Please select all that are relevant to you

Paying Position(Required)

Second Paying Position(Required)

Polo Shirt Size(Required)

Casual Shorts(Required)

Playing Jersey(Required)

Playing Shorts

Playing Socks(Required)

Medical Information

Parent/Gaurdian Name(Required)

First Last

Email(Required)

Phone(Required)

Date of last tetanus vaccine

MM slash DD slash YYYY

Do you suffer from any of the following?

Migraines/Headaches

Respiratory Illness

Diabetes

Skin Problems

High Blood Pressure

Please Specify(Required)

Are you required to take prescription medication whilst on tour?(Required)

Yes

No

Please Specify(Required)

Do you have pre-existing injuries or illnesses that we should be aware of?(Required)

Yes

No

Please Specify(Required)

Do you have any special dietary needs?(Required)

Yes

No

Please Specify(Required)

Health Care Information

Medicare Number(Required)

Do you have Private Health Cover?(Required)

Yes

No

Does your policy include ambulance cover?(Required)

Yes

No

Private Health Fund

Member Number

Please provide any further information here:

Football West Touring Team Code of Conduct(Required)

I agree to the Football West Touring Team Code of Conduct

Consent(Required)

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