Player Exemption Request Player Exemption Request Is the Exemption for more than one match?(Required) Yes No Exemption Start Date(Required) DD slash MM slash YYYY Exemption End Date(Required) DD slash MM slash YYYY Date of Match(Required) DD slash MM slash YYYY Player Name(Required)Player FFA Number(Required)Date of Birth(Required) DD slash MM slash YYYY Gender(Required) Male Female Club(Required)Competition(Required) Regular Season Cup Top 4 Cup Current Team(Required)Exemption to Play in the Following Team(Required)Is this Exemption for a Goal keeper?(Required) Yes No Reason for Exemption?(Required)MedicalFamilyOtherIf the selected reason is medical, attach the player's medical certificate here:(Required) Drop files here or Select files Max. file size: 128 MB. Please explain the reason for requesting the Exemption(Required)Please attach any further information to support the exemption request (e.g flight itinerary or evidence of matches played) Drop files here or Select files Max. file size: 128 MB. Club Contact Name(Required)Club Contact Email(Required) Club Contact Phone Number(Required)