Football Player Transfer/Clearance Form

This form is to request to be cleared from your current Club and transferred to the Golden Square Football Netball Club - Juniors.

If clearance is approved, you will be advised by email and then required to complete an online registration form and will be subject to the Club's Player & Team Selection Policy.

This is a legal document - by signing you will be bound by the terms and conditions contained in this contract.

Player's Full Name (including middle name): *
Date of Birth: Date of Birth: * / DD / MM YYYY
Gender: *
Player HQ Number (if known):
Street Address of player: *
City: *
Postcode: *
Parent/Guardian Full Name: *
Contact Phone Number: *
Email: *
Name of Club you're wishing to leave: *
Name of the league that the Club belongs to: *
Were you a representative player in the previous season (eg; academy)? *
Your reason/s for wanting to transfer between Clubs: *
Age group that you wish to play for with Golden Square: *
Do you owe your previous Club money or any item of property (such as a playing jumper)? *

Do you owe your previous Club money or any item of property (such as a playing jumper)? Yes No
Have you ever been disqualification by any League (tribunal, executive etc) or a Club? *

Have you ever been disqualification by any League (tribunal, executive etc) or a Club? Yes No
Are you currently under disqualification by any League (tribunal, executive etc) or a Club? *

Are you currently under disqualification by any League (tribunal, executive etc) or a Club? Yes No
Please list any other Clubs you have played for prior to the one you're transferring from and the periods you were registered there:
Does your family you have any current or past affiliation with Golden Square Football Netball Club (either the Senior or Junior Club)?
Acknowledgement

I seek permission to play with the Golden Square Football Netball Club - Juniors, subject to the application which I have made for a clearance to the Club being granted (if applicable) and subject to due compliance with the requirements of the Bendigo Junior Football League. I acknowledge that I have read the conditions of registration and the AFL Victoria Country Privacy Policy and agree to be bound by those conditions. I also authorise the Bendigo Junior Football League to advise my former league of this application (where applicable). I DECLARE that the above particulars are to the best of my knowledge, and belief, true and correct.
Parent/Guardian to sign (due to player being under the age of 18): *

Draw or Type

I understand this is a legal representation of my signature. Clear

Full Name

I understand this is a legal representation of my signature.

Football Player Transfer/Clearance Form

Football Player Transfer/Clearance Form

Acknowledgement