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Last name*

Phone number*

Email address*

Address*

Additional information

Club/Association*

Do you have a Blue Card?*

Under 18 Boys 25-28/4/25 Cairns

Selector

Coach

Manager

Umpire

Technical Officer

Under 18 Girls 25-28/4/25 Townsville

Selector

Coach

Manager

Umpire

Technical Officer

Under 16 Boys 21-24/9/25 Brisbane (SHC)

Selector

Coach

Manager

Umpire

Technical Officer

Unders 16 Girls 21-24/9/25 Gold Coast

Selector

Coach

Manager

Umpire

Technical Officer

Under 14 Boys 6-9/7/25 Rockhampton

Selector

Coach

Manager

Umpire

Technical Officer

Under 14 Girls 29/6-2/7/25 Toowoomba

Selector

Coach

Manager

Umpire

Technical Officer

Event Waiver

By nominating on line:

I agree to fulfil the duties of the role to which I am appointed
I agree to abide by the Fraser Coast Hockey Code of Conduct when acting on behalf of the teams should I be appointed.
I will provide my Blue Card number upon appointment or apply for one if required.

I confirm that I have read the above Event Waiver in its entirety.*

I agree to the Event Waiver.*

2025 Fraser Coast Representative Team Officials

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