Matthew McGregor Northern Development Officer Hockey Tasmania Inc.

Northern Hockey Centre PO Box 396, Newstead, TAS, 7250 Tel: 0433 788 728 e: matthew@hockeytas.com.au www.hockeytas.org.au

2013 NORTHERN JUNIOR INTRA-STATE NOMINATIONS

Any player wishing to be considered for selection into any of the Northern Teams competing in the Junior Intra-state Series being held at the Tasmanian Hockey Centre, New Town over the June Long Weekend starting on Saturday the 8th and Sunday the 9th of June should complete the attached nomination form and return via email or mail to Matthew McGregor, with the $10 nomination fee payment details included. Further training costs will be involved for a successful nomination. For further information, phone Gai Cross (6327 2877) or Matthew McGregor 0433 788 728) or via email as above.

Age eligibility is taken from 1st January 2013 NOMINATIONS CLOSE THURSDAY 11th APRIL 2013
LATE NOMINATIONS MAY BE CONSIDERED! INITIAL TEAM SELECTION DETAILS ARE PROVIDED BELOW WEEKLY TRAINING SCHEDULE TO BE ADVISED AS TIMES ARE CONFIRMED!

INITIAL SELECTION TRIALS SUNDAY 14th APRIL 2013

AGE U13 BOYS TRIALS SUNDAY 14th APRIL 2013 9:00am: U13B Registration & Warm-up 9:00am 10:30am: Turf Session Ground: NHC1 SUNDAY 14th APRIL 2013 10:30am: U15B Registration & Warm-up 10:30am 12:00noon: Turf Session Ground: NHC1 SUNDAY 14th APRIL 2013 12 noon: U18B Registration & Warm-up 12 noon 1:30pm: Turf Session Ground: NHC1 GIRLS TRIALS SUNDAY 14th APRIL 2013 9:00am: U13G Registration & Warm-up 9:00am 10:30am: Turf Session Ground: NHC2 SUNDAY 14th APRIL 2013 10:30am: U15G Registration & Warm-up 10:30am 12:00pm: Turf Session Ground: NHC2 SUNDAY 14th APRIL 2013 12 noon U18G Registration & Warm-up 12 noon 1:30pm: Turf Session Ground: NHC2

U15

U18

***Please arrive at St. Leonards no later than 15 min prior to your start time to register.***

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2013 NORTHERN JUNIOR INTRA-STATE NOMINATION FORM

Name Street Address Phone (h) Email Address Club/School Team Preferred Playing Position/s I wish to nominate for inclusion in the following Northern Junior Intra-state Team in 2013 (Please tick the appropriate team) U13 BOYS U13 GIRLS U15 BOYS U18 BOYS U15 GIRLS U18 GIRLS Suburb Parents Phone (m) (Essential as team information will be sent to this email address) Playing Shirt Size D.O.B. Post Code

I understand and accept the commitments relating to the team, including the requirement to attend all training sessions and team meetings as advised by team officials; to make prompt payments for expenses incurred as a Team Member; and to represent the NCC to the best of my ability. Players Signature: Parents Signature: Date: Date:

Direct Bank Deposit

HOW TO PAY

Credit & Debit Card Payments

Credit & Debit Card Payments will be accepted on the day OR Complete the Credit Card details below and post to; PO Box 396, Newstead, 7250

Account Name: Hockey Tasmania Inc. BSB: 067-028 Account Number: 2801 1822 Quote Reference #: JLWN_Your Surname Send confirming email to accounts@hockeytas.com.au

Cheque by Mail
Send this form with your cheque made payable to Hockey Tasmania Inc to; PO Box 396, Newstead, 7250

Amount Paid:

Card Holders Name:

Card Number:

Signature:

Expiry Date: