2025 NSW State Team Program - Athlete Acceptance

Water Polo NSW State Team Program – Athlete Acceptance Form

Congratulations on being selected for the NSW State Team Program. Please complete the below form to accept your position in your respective team.

Select your age range*

Select your gender identity*

Male

Female

Non-Binary

Differently identify

Enter your post code*

Enter your email address*

Athlete Full Name*

Athlete DOB*

Athlete Club*

State Team*

Please select one of the below.

U15 Boys

U15 Girls

U17 Boys

U17 Girls

Athlete Emergency Contact - Name*

Athlete Emergency Contact - Mobile Number*

Athlete Emergency Contact - Email Address*

Does the athlete have any medical conditions or illnesses coaches or management staff should be aware of?

If yes, please provide details.

Does the Athlete have any Dietary Requirements, intolerances or allergies?*

Please specify.

Does the athlete have any current injuries?

If yes, please provide details.

Do you accept that the athlete levy for the 2025 NSW State Team Program is $2,850 + GST per athlete.*

Yes

Do you always acknowledge that you are bound by the relevant WPNSW & WPA Codes of Conducts and Policies?*

Yes

Do you accept that failure to pay your athlete levy in the prescribed timeframe may result in your suspension from the 2025 NSW State Team Program?

Yes

Do you understand that all uniform will be purchased direcyly through Kap 7 at an additional cost to the WPNSW Levy?*

Yes

Finally, do you accept your invitation as part of the WPNSW State Team Program competing at National State Championships?*

Yes

Water Polo NSW respectfully acknowledges the Traditional Custodians of the lands in which we are on. We pay our respects to Elders past, present and emerging.

We are committed to a positive future for all Aboriginal and Torres Strait Islander communities and to honor their ongoing cultural and spiritual connections to this country and recognise the role and value of culture.

We are a proudly diverse organisation, who actively celebrates LGBTIQ+ diversity, inclusion, and pride.

Select your gender identity*

Enter your email address*

© 2025 Water Polo NSW