2025 Winter

THIS FORM IS FOR PRIMARY TO SENIOR GRADES – DO NOT USE FOR SUB PRIMARY GRADE

Winter Trials Form

Player Information

Name(Required)

First Last

Date of Birth(Required)

Gender(Required)

Player Email(Required)

Second Player Email(Required)

Player Mobile Number(Required)

Address(Required)

Street Address Suburb Postcode

Are you of Aboriginal and/or Torres Strait Islander origin?(Required)

Do you identify yourself as living with a disability/disabilities?(Required)

Please list the disability/disabilities you identify living with

Game Day Polo/Tee size(Required)

Emergency Contact Details

Emergency Contact Name(Required)

First Last

Relationship to Player(Required)

Emergency Contact Mobile Number(Required)

Trial Information

Position #1(Required)

Position #2(Required)

What Club did you play for in 2024?(Required)

What age group and grade did you play in 2024?(Required)

How many seasons have you played for Contax?(Required)

Are you available for all trials?(Required)

Please list the dates/times you are not available

SENIORS ONLY: Do you wish to be in contention for selection in AMND League and A Grade?

Are you a School Boarder?(Required)

Please list if someone has recommended you attend Contax trials

Would the player or parent/caregiver be interested in umpiring for Winter 2025?(Required)

Please provide name, contact details and experience(Required)

Would the player or parent/caregiver be interested in coaching for Winter 2025?(Required)

Please provide name, contact details and experience(Required)

Do you have any existing medical conditions/illness/allergies?(Required)

Please list your existing medical conditions/illnesses/allergies(Required)

Nomination Fees

Please note that all Winter Nomination Fees must be paid at time of nomination.

Processing fee

Nomination Fee(Required)

All Grades ($506)

Player Life Members ($280.50)

Total

Credit Card(Required)

MasterCard

Visa

Card Number

Expiration Date

Security Code Cardholder Name

This field is for validation purposes and should be left unchanged.