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ROYAL PARK TOUCH ASSOCIATION |
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TEAM / PLAYER REGISTRATION FORM |
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SUMMER 2007/08 |
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TEAM NAME: |
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TEAM COLOUR: |
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TEAM CONTACT: |
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TEAM REFEREE |
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DIVISION (circle): |
Mixed               B           C            D |
DEPOSIT PAID |
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DAY/NIGHT: |
Wednesday |
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PAYMENT METHOD |
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FIRST NAME |
SURNAME |
M/F |
ADDRESS |
SUBURB |
CODE |
D.O.B. |
PHONE |
EMAIL |
| 1 |
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| 2 |
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| 4 |
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| 5 |
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| 7 |
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| 8 |
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| 9 |
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| 10 |
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| 11 |
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| 12 |
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| 13 |
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| 14 |
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| 15 |
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| 16 |
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| PRIVACY STATEMENT |
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| Australian Touch Association (”ATA”) is committed to the protection of your personal information. Any personal information you provide to ATA will be used for |
| the following purposes and related purposes which can be reasonably expected: |
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| Membership administration and playing statistics; and communicating commercial information |
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| Please tick the box on the right if you do not wish for your personal information to be used in respect of that purpose. |
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| ATA will not disclose any personally identifiable information obtained from you to other parties or for purposes other than those stated above, |
| unless you provide your written consent to us, with the following exceptions: |
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| Where there are grounds to believe that disclosure is required in order to prevent a threat to health or life; where ATA suspects that unlawful activity |
| is or has been engaged in, such personal information maybe used to investigate the suspected unlawful activity; or the use is authorised |
| by law or reasonably necessary to enforce the law. |
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| Information that you provide through various means will be kept safe and secure within ATA. At anytime, you may also notify us if you do not wish to receive |
| marketing materials or other communications from ATA. Please put this request in writing and send to the address below. |
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| Should your contact details or address change, please inform us. |
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| If you have any queries or concerns about your personal information which ATA maintains, please send the details of your query or concern in writing to ATA. |
| Thank you for taking the time to read this important statement. (P.O. Box 9078, Deakin, A.C.T. 2600) |
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| In signing this form I agree to comply with the rules, regulations and by-laws of the Australian Touch Association Incorporated, my State/Territory Association |
| and my Affiliate and agree to be covered by the Sports Personal Accident Insurance Policy as arranged by the Australian Touch Association through |
| SportsCover Australia P/L T/A Sportscover. |
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| Policy details are available from your affiliate bodies. |
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| _________________________________________________ |
Date:Â Â Â Â /Â Â Â Â Â / |
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| Parent / Guardian Signature |
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| If you are under the age of 18 years, your parent or guardian must sign and date this form. |
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| _________________________________________________ |
Date:Â Â Â Â /Â Â Â Â Â / |
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| Participant Signature |
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