Jimboomba Little Athletics
info@jimboombajetslac.org.au
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Henderson Road, Jimboomba
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Trialist 2024/25
Trialist Form
Athlete's Name
Athlete's Name
First
First
Last
Last
Email
Contact Number
Gender
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Female
Date of Birth
Day
1
2
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Month
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Year
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Age Group
Tiny Tots Trial Nights - please select your preferred 2 nights below
First Trial Night
*
Second Trial Night
*
U6 - U9 Trial Nights - please select your preferred 2 nights below
First Trial Night
*
Second Trial Night
*
U10 - U20 Trial Nights - please select your preferred 2 nights below
First Trial Night
*
Second Trial Night
*
Parent/Guardians Name
Signature
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Parent/Guardian Declaration In consideration of my Child/Children trialing Little Athletics at this Centre, by signing above I acknowledge and consent to: 1. Abiding by all the Queensland Little Athletics Association (QLAA) rules and regulations, including those pertaining to trialists, myself as a parent/guardian and those relevant to this Centre 2. Any member of this Centre to seek emergency medical treatment for my child should they deem it necessary 3. This Centre and QLAA keeping this form and any medical information provided on file in accordance with the QLAA Privacy Policy 4. QLAA Privacy Policy can be viewed at www.qlaa.asn.au
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