SCHOOL SPORT WA

PO Box 8224, Perth Business Centre, WA 6849  ABN: 25 492 318 440  school.sport@det.wa.edu.au

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Secondary Triathlon Individuals Nomination

**Enter your details and press submit at the bottom of page**

Please do not print a blank form and hand write your details as your nomination will not get through to the Sport Coordinator.

Champion Schools Individual Nomination Form 2012

School Details:

School Name:

 

Suburb:

School Phone:

Details of Teacher(s) in Charge: [Note: HOD/TIC Phys Ed and Teacher in charge of this sport both required]

School HOD/TIC Physical Education
First   Surname   Email Mobile

Teacher coordinating this sport in school
First   Surname   Email Mobile

Important: All relevant sport information and competition updates will be sent to these email addresses

Principal Authority:

A condition of participation is schools compliance with Department of Education  Policies and Guidelines as they relate to excursions.  My school Principal is aware of, and endorses, this team(s) nomination.      

Yes (Please click)

Principal's Signature:____________________________________

For School Records Only: We suggest you print this form, present to your Principal and keep for your records - you are not required to bring this to the event or submit to the SSWA office.

Competition Details:

Individual Competitor Entry

Please type in your details and retrieve your competitor number from the website 2 days prior to the event.

First name Surname DOB
     
Select your race category.

Junior Girls

Junior Boys

Intermediate Girls

Intermediate Boys

Senior Girls

Senior Boys

  

 

School Nomination

Please see School Nomination form on the main Triathlon page

 

Nominations Due: 1 November 2012 Nomination Fee: $30 for Individuals (payable on the day)

                            $30 per team subject to change dependent on nomination numbers

                            $20 Novices (SSWA will invoice schools) Late nominations may be accepted but, if successful, a penalty fee will be imposed.

When you submit this form it will be emailed to the Sport Coordinator.

Stuart Denton

Duncraig SHS

stuart.denton@det.wa.edu.au

For your records please print a copy of the form before submitting

 

For security reasons we require you to enter a code word prior to hitting the submit button.

Code Word [use lowercase]: sswa       Enter code word here