2014/15 High Performance Squad selection

The following Specific Criteria applies in determining selection for the New Zealand and New Zealand Development team to compete at Rescue 14.

A New Zealand and New Zealand Development squad will be selected and announced at the conclusion of the 2014 NZ Surf Life Saving Championships.

Please note the Specific Criteria is a Schedule to the SLSNZ Selection Regulation and must be read as part of, and in conjunction with that Regulation. In particular it is noted that the Specific Criteria applies in addition to the Overall Objectives and General Criteria set out in the SLSNZ Selection Regulation.

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* 1. First Name

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* 2. Last Name

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* 3. Gender

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* 4. Date of Birth

DD/MM/YYYY

Date

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* 5. SLSNZ Membership Number

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* 6. Passport number

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* 7. Club

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* 8. e-mail address

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* 9. Phone number

Primary

Secondary

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* 10. Postal address

Street Address (e.g. 7 Southgate Road)

Suburb (e.g. Island Bay)

City (e.g. Wellington)

Postal Code (e.g. 6023)

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* 11. Mark those that apply to you

I hold a current NZ Passport that is valid for at least 6 months after September 2014

I am available to travel with the team in September 2014

I agree to pay an athlete contribution towards the campaign of $1,000 (or if in the U18 a full user-pays amount of an estimated $7,000)

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* 12. Tog size

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* 13. Polo t-shirt size

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* 14. Jacket size

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* 15. Any other comments

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* 16. Athlete Declaration

At the time of submitting this form:
1. I acknowledge I have read and understood the SLSNZ Selection Regulation (available here - insert hyperlink) and I agree to comply with it;
2. I acknowledge that I have been given access to the Sports Anti-Doping Rules (available here - insert hyperlink) made by DFSNZ under the Sports Anti-Doping Act 2006 (and adopted as the SLSNZ antidoping policy) which I have read and understood, and I agree I am bound by the provisions contained within those Rules;
3. I agree to comply with the constitution of SLSNZ, together with all Regulations, Policies and reasonable directions of the Board and the Chief Executive;
4. I declare that I am a current and financial member of the SLSNZ Club named in this application;
5. I declare that I hold a current refreshed SLSNZ Lifeguard Award;
6. I declare that I am a New Zealand Citizen;
7. I acknowledge that my only right of appeal in respect of my non-selection is as set out in clause 8 of the SLSNZ Selection Regulation;
8. I understand that I will be required to sign the SLSNZ Athlete Agreement if I am selected to a SLSNZ New Zealand squad or team.

Yes