Registration

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Completing this registration form secures a place at a no-obligation, free information session where V Squad staff and coaches will explain the program in detail.

You can enrol in the V Squad Academy using your account details at any time with enrolments closing in early September.

Which information session will you attend? * Select information session * Ballarat (Details to be confirmed)Bendigo (Details to be confirmed)East Metro (Details to be confirmed)Frankston (Details to be confirmed)Geelong (Details to be confirmed)Online Webinar #1 (Details to be confirmed)Online Webinar #2 (Details to be confirmed)Shepparton (Details to be confirmed)Traralgon (Details to be confirmed)West Metro (Details to be confirmed)

Which regional session will you most likely attend? * Select regional camp * Ballarat Training SquadBendigo Training SquadGeelong Training SquadMelbourne Metro Training SquadShepparton Training SquadTraralgon Training Squad

Child Details

First Name * Child's first name *

Last Name * Child's last name *

Date of Birth *

Email * Child's email *

Mobile/Phone * Your mobile or phone number (10 digits with no spaces) *

Junior Club * Child's junior club *

Primary School * Child's primary school *

Secondary School Child's secondary school

TAC Club Region * Select TAC club region * Bendigo PioneersCalder CannonsDandenong StingraysEastern RangesGeelong FalconsGippsland PowerGreat Western Victoria RebelsMurray BushrangersNorthern KnightsOakleigh ChargersSandringham DragonsWestern Jets

SSV Region * Select SSV region * Eastern MetroGippslandGreater Western VictoriaHumeLoddon MalleeNorthern MetroSouthern MetroWestern Metro

SSV U12 State Team Member? * Yes      No

Nominated By Child nominated by

Selection Criteria * Select selection criteria * Top 5 Club Best and FairestTop 10 League Best and FairestSSV Regional trialsCoach NominationV Squad InvitationInterleague RepresentativeOther

Emergency Contact Details

Name * Emergency contact name *

Phone * Emergency contact number (10 digits with no spaces) *

Junior Coach Details

First Name Coach's first name

Last Name Coach's last name

Email Coach's email address

Parent/Guardian Details 1

Title * Select parent/guardian title * Mr Mrs Miss Ms Dr Sir Prof

First Name * Parent/guardian first name *

Last Name * Parent/guardian last name *

Address * Parent/guardian address line 1 *

Parent/guardian address line 2

Suburb * Parent/guardian suburb *

State * Select state * VIC NSW QLD ACT NT WA SA TAS OTHER

Postcode * Parent/guardian postcode *

Mobile/Phone * Parent/guardian mobile or phone number (10 digits with no spaces) *

Email * Parent/guardian email address *

Parent/Guardian Details 2

Title Select parent/guardian title Mr Mrs Miss Ms Dr Sir Prof

First Name Parent/guardian first name

Last Name Parent/guardian last name

Address Parent/guardian address line 1

Parent/guardian address line 2

Suburb Parent/guardian suburb

State Select state VIC NSW QLD ACT NT WA SA TAS OTHER

Postcode Parent/guardian postcode

Mobile/Phone Parent/guardian mobile or phone number (10 digits with no spaces)

Email Parent/guardian email address

Account Details

Email

Password * Your password * Password Strength:

Confirm Password * Confirm password *

How you heard about the program? Select Club/Coach NominationFacebookFriend or family memberInstagramInterleagueLeague Training SessionOtherSchoolSSV TrialsWebsite

Confirmation * I agree and acknowledge the terms & conditions outlined in this agreement.
Your submission of this form confirms that you have read and agree with our terms & conditions.

Verify User *

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