Baseball Interstate Nomination FormStudent DetailsName* First Last Date of Birth* Day Month Year Gender* Female Male Email* Enter Email Confirm Email Full School Name* Does your child have any medical conditions that the Team Officials need to be aware of?* Yes No Please provide details of this condition and who to contact in an emergency.*Parent/Guardian DetailsName* First Last Telephone* Email* Enter Email Confirm Email School Notification* I understand it is a parent/student responsibility to notify the school of this nomination. Team Specific DetailsCurrent Club* Nominated PositionsFirst Choice Second Choice Are you trialing for Baseball WA's National Teams?* Yes No PhoneThis field is for validation purposes and should be left unchanged.