Trainer Application - St Marys Junior Rugby League

All applications MUST be supported by a completed Working with Children Check.

Personal Information

Name(Required)

First Last

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Date of Birth(Required)

Occupation(Required)

Contact Number(Required)

Email Address(Required)

Polo Shirt Size(Required)

St Marys Rugby League Club Membership Number(Required)

Club History

Are you a past/present member of St Marys Rugby League Club?(Required)

Please state number of year’s service with St Marys Rugby League Club:

Coaching(Required)

Playing(Required)

Other

Training Qualifications

Do you hold a current Trainers Accreditation?(Required)

League Safe (Yellow Shirt)(Required)

Sports Trainer Level 1 (Blue Shirt)(Required)

Sports Trainer Level 2 (Orange Shirt)(Required)

Are you a New Trainer?(Required)

Would you like to attend a Trainers course?(Required)

Have you completed a current Working with Children Check?(Required)

Working with Children Check Number

Working with Children Check Expiry Date

Team Nomination

Name the age team you would like to Train

Age(Required)

Division(Required)

Do you have a child playing in this team?(Required)

It is a requirement of undertaking the role that you are double vaccinated against COVID-19 or hold a Medical Contraindication. Proof will be requested.(Required)

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