2024 Fuel to Go & Play Club Championships - Permit Request Form

Club/Association

Club/Association Contact

Mobile

Email

By completing this Permit Player Request Form, you are seeking permission from Hockey WA for a player outside of your Club/Association to participate in the Junior WA Club Championships with your team. Please complete a separate form for each team.

Team Identification

Outline which teams the request relates to.

Player(s) Name(s)

Player(s) History

Including representative teams

Player(s) relationship to Club Requesting Permit

Club's reason for seeking permit