RACT Nomination Form

2018 MASTERS STATE TEAM

Rower and Coxswain Nomination Form

This form is available until 5pm Friday 16 March 2018
Full Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

SuburbState / Province

Post Code
E-mail*
Phone Number*
Date of Birth*

MonthDayYear
Gender*
Member Club*
Nominating as:*

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In submitting this nomination I declare I have read and understand the Rowing ACT Masters Selection Policy 2018. In addition I declare I have read and understand the Rowing Australia Member Protection Policy and agree to uphold the principles contained therein.*

I agree
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