Worksafe Victorian Country Football League Clearance/registration Form

WORKSAFE VICTORIAN COUNTRY FOOTBALL LEAGUE

CLEARANCE/REGISTRATION FORM

YEAR 20……

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

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Middle Name

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Player Registration No.

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Home Phone

Mobile Phone**

Work Phone

Mobile Parent / Guardian**

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Email Address**

Email Parent / Guardian**

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Occupation ................................................................................................................. If student, are you fulltime?

Yes

No

AFL Club you support ................................................................................................ Auskick Centre .....................................................................

Apply for registration with the .......................................................................................................................................... Football Club (“the Club”)

affiliated with the ....................................................................................................................................................... Football League (“the League”)

Players over 18 to complete

1. Are you currently bound by a written contract to the club from which you seek a transfer from?

(Please note that all contracts automatically expire on 31 October. In the case of a multiple year agreement, the contract will expire on

31 October in the final year of the agreement)

Yes. You cannot obtain a transfer while you are under contract,

No. Go to question 3.

unless you believe that the club is in breach of the contract. If so, go to question 2.

Players over 18 to complete

2. I believe that the club is in breach of my current playing contract?

Reason club is in breach: .....................................................................................................................................................................................

.......................................................................................................................................................................................... (Now go to question 3)

All Players to complete Questions 3, 4 & 5

3. Do you owe your previous club money or any item of property?

Yes. Do not proceed. You cannot transfer while you owe money or property to your previous club.

No. Go to question 4.

4. Are you currently under disqualification by any League (tribunal, executive etc.) / club?

Yes. Go to question 5.

No. Go to question 5.

5. Have you ever been disqualified by any League (tribunal, executive etc.) / club?

Yes. You will not be permitted to play with your new club until your tribunal history has been received by the League and the league

approves your request to play.

No. Sign acknowledgement in Section One and lodge form. Your former club will have 6 clear business days to respond,

once notified of the transfer application.

Apply for a clearance from the...............................................................................................................................................Football Club affiliated

with the ............................................................................................................................................................................................. Football League

For the following reasons:-..........................................................................................................................................................................................

Prior to this application I played with the following clubs for the periods named:-

(a)................................................ Club, affiliated with the ........................................... F.L. from .......…../ .......……/..……to .......... /........... / ............

(b)................................................ Club, affiliated with the ........................................... F.L. from........…../ .......……/..……to .......... /........... / ............

(c)................................................ Club, affiliated with the ........................................... F.L. from....... …../ .......……/..……to .......... /........... / ............

I seek permission to play with the Club, 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 League with which the Club is affiliated. I acknowledge that I have read the conditions of registration and WorkSafe VCFL Privacy Policy herein and

agree to be bound by those conditions. I also authorise the league to which I desire registration, to advise my former league of this application. I DECLARE that the above

particulars are, to the best of my knowledge, and belief, true and correct.

Signature of Player ....................................................................................................

Date……/……../.................

(If the Player has not attained the age of 18 years) Parent’s/Guardian Signature ....................................................................................................

Signed ..................................... Position............................................ for ............................................. Football Club

Date……/……../ .............

*To get full value from your VCFL Registration, a valid e-mail address and/or mobile number is vital.

**Required to be completed by parents of players under 18 years of age and players over 18 years of age

Please tick the box if you do not wish to receive information from the WorkSafe VCFL or it’s official partners.