South West Junior Hockey

SOUTH WEST JUNIOR HOCKEY CHAMPIONSHIPS

“SMARTER THAN SMOKING’

NOMINATION FORM 2013

Club Details

Event Date: / Saturday 1st June – Monday 3rd June 2013 /
Club Name: /
Club Colours: /
Club Contact: /
Address: /
Phone: /
Mobile Phone: /
Fax: /
Email Address: /
Accommodation Details / Arriving Friday Night Yes/No
(For Fixture Assistance) /

Please indicate the number of teams in each division Maximum of two team per age group/division:

Eg 15 boys Div 1 - 2 teams and 15 boys Div 2 2 teams is allowed.

You may advise if you have a third side and if a group is short then you will be contacted.

CHAMPIONSHIPS DIVISION
AGE GROUP / # / AGE GROUP / # / $
15 BOYS (J9/10) Max 2 teams / 15 GIRLS (J9/10) Max 2 teams / $
13 BOYS (J7/8) Max 2 teams / 13 GIRLS (J7/8) Max 2 teams / $
11 BOYS (J5/6) Max 2 teams / 11 GIRLS (J5/6) Max 2 teams / $
CARNIVAL DIVISION
AGE GROUP / # / AGE GROUP / # / $
15 BOYS (J9/10) Max 2 teams / 15 GIRLS (J9/10) Max 2 teams / $
13 BOYS (J7/8) Max 2 teams / 13 GIRLS (J7/8) Max 2 teams / $
11 BOYS (J5/6) Max 2 teams / 11 GIRLS (J5/6) Max 2 teams / $
TOTAL / $

In completing this form on behalf of the above Team(s), I agree to abide by the rules of the Championships and the Committee’s decisions and to compete with a fair sporting spirit. We undertake not to hold the Management Championship Organisers liable for any damage in respect to any claims made in relation to events and or functions being held as part of or in conjunction with the South West Junior Hockey Championships/Carnival.

Nomination fees: $250.00 incl GST per team.

Nomination fee to be paid to confirm your nomination, due to number restrictions, please forward nominations and fees ASAP

Cheques payable to: “ Bunbury & Districts Hockey Stadium”

EFT: 066 507 00907338 – Reference - Team/Club Name

Nominations to: SWJHC, PO Box 1662, Bunbury WA 6231. Fax: 9795 5090.

Email: (Include SWJHC in subject line).

Contact: Sue Neaves Phone: 9795 5160. Mobile: 0413 510 580.

Nominations Close MAY 17th, 2013.