football4all Gala Day – Individual Registration

Individual Registration Form

Football NSW will be hosting the Annual football4all Gala Day on Sunday 18th June 2023 at Valentine Sports Park, 235-257 Meurants Ln, Glenwood, NSW, 2768.

The gala day will run from 9am to 3pm.

The below nomination form is for individuals that wish to take part in the football4all Gala Day that ARE NOT part of a current football4All program.

Please complete by 5th June 2023.

If you wish to enter a TEAM into the football4All Gala day please register HERE

Please select your FOOTBALL4ALL program*

If other, please indicate club/group

Individual Player Submission

Please nominate the category which best suits the participant.

We will try our best to fit individuals with others of similar age groups and ability level based on the below questions.

The below categories are only to be used as a general guide and may not be strictly adhered to as the aim of this gala day is to provide a fun football experience for as many of our members as possible.

Name:*

First Last

Email:*

Postcode:*

Please select ONE of the following categories:*

Category 1 (Age 5-9)

Category 2 (Age 10-14)

Category 3 (Age 15-20)

Category 4 (Age 21+)

Please select ONE of the following ability level*

Intellectual

Sensory

Physical

Neurological

Cerebral Palsy, Acquired Brain Injury or Stroke

Powerchair

Learning Disabilities

Mental Illness

Please provide any additional information that may assist FNSW

Emergency Contact Details

Please provide emergency contact details of a parent/guardian/carer present on the day of the football4all gala day.

Emergency Contact*

First Last

Emergency Phone Number*

Emergency Email*

Important Information

Football NSW and approved media outlets will be filming various games and presentations at this event. Approved photographers from FNSW and local media may also be in attendance.

Football NSW is aware that some participants in this event may currently be or have previously been in Out of Home Care (OOHC) or a Ward of the State, and therefore their name or any identifying information (which would include their image) is protected under the Children and Young Persons (Care and Protection) Act 1998 (Act) and is not permitted to be published until the child or young person turns 25 years of age.

To ensure compliance with the Act, please notify Football NSW of any participants in this event who are currently or have previously been in OOHC or a Ward of the State. This can be notified either prior to or upon registration arrival.

If you have any enquiries, please contact Annabel Meadley

Do you have any participants who are or have been in Out of Home Care (OOHC) and are under 25 years of age?*

Yes

I agree to the above information