Sporting Wheelies and Disabled Association ______

Volunteer Registration Form

Hells Bells Goalball Championships - Cairns

Date: Saturday 15 to Sunday 16 July 2017

Time: 9am to 5pm (approximately)

Address: Cairns State High School, Cnr Sheridan St & Upward Street, Cairns City QLD 4870

Your contact details:
Name: / Date of birth: / Gender: M F
Home phone: / Mobile number:
E-mail address:
Postal address:
Emergency contact details:
Emergency contact person: / Relationship:
Emergency contact phone number:
Emergency contact address:
Same as volunteer
Other:
Additional information:
Do you have a current Blue Card (Queensland working with children and young people check)?
Yes Name (as it appears on the card):
Card number: Expiry: //
No It is a requirement that all Association volunteers have a current Blue Card. We will assist you with this process.
Please note that it is an offence for a disqualified person to sign a blue card application.
Allergies or dietary requirements? No Yes (if Yes please specify)
Please indicate your interest in the following roles:
Drivers (must be over the age of 25) Current driver’s license: No Yes
Licence number:Class:Expiry://
Manual Scoresheet Attendants – training will be provided
10 Second Timer – training will be provided
Goal Judge – training will be provided
Photographer – with own camera
Please indicate your availability:
Friday 14 July 2017: driver only required , all day or specify time:
Saturday 15 July 2017: all positions required , all day or specify time:
Sunday 16 July 2017: all positions required , all day or specify time:
Training: Cairns State High School Cnr Upward and Sheridan Street Cairns
To ensure your volunteer participation is a positive experience you will be provided skills based training and information for your role. Your attendance is an essential requirement. Please choose one of the following training dates:
Wednesday 28 June 2017, 5.30pm to 7.30pm
Wednesday 5 July 2017, 5.30pm to 7.30pm
Please send me information on the following further events:
Any sport/event / Boccia / Goalball / Football
Powerlifting / Wheelchair basketball / Wheelchair rugby / Gym/fitness
Recreation programs / Other, please specify:
Free publications – keep up-to-date with news and events
I would like to receive:
Monthly news update (email only) Annual Report (post only)
This form may be used as an alternate membership form for new volunteers registering for an event.
Terms and conditions of membership
Volunteers are not required to be financial members of the Association, however, if you wish to participate in activities, programs and events (eg. access the Association gym (Brisbane); playing in social goalball / boccia / wheelchair basketball / wheelchair rugby programs, wheelchair basketball state championships, etc.), then you will need to join as a financial member.
I understand if admitted to membership as a non-financial member/volunteer, I may be liable for an annual membership fee as specified if using the Association’s facilities or services.
The Association ensures that all member details are securely maintained. Members’ details are not provided to any third party without consent.
The Association is committed to proving an environment that promotes positive behaviour and values, one that is free from all forms of harassment, discrimination and abuse, and one that is safe for children.
I consent / do not consent to the publication and/or use in any form of media whatsoever of my name, image, voice, statements or otherwise, before, during or after any event/competition/Association service or program, whether for advertising, promotion or otherwise, without payment or compensation.
I agree to present the Association in a positive manner in any media opportunity.

To assist us with our planning of this event, please complete and return this form to Susan Solakovic, HR and Volunteers Coordinator, by Wednesday 5 July 2017.

Sporting Wheelies and Disabled Association

60 Edmondstone Road, Bowen Hills Qld 4006

Ph: (07) 3253 3333 Fax: (07) 3253 3322

Email:

Signature: Date://

Office use only
Date Rec’d:____/____/____ / Date on database: ____/____/____ / Acknowledgement sent:____/____/____

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