Membership Application

Membership Application
As School Principal, I hereby apply for (school name) to be admitted as a member of the North West Junior Soccer Association Inc. (NWJSA) for the (year) season.
School Name*
I Will:*
Do all that is reasonable to ensure the School, its officers, players, parents/caregivers and volunteers will at all times abide by the constitution, rules and regulations and policies of the NWJSA.Acknowledge NWJSA Regulation 4.1 stipulation that the school player registration form will include a Player, Parent and Spectator commitment to comply with NWJSA Codes of Conduct and Policies.Acknowledge that a requirement of participation with NWJSA is a Player Personal Accident Insurance cover of $1,000,000. If the School does not provide this level of insurance, the School will obtain this insurance via the options offered by NWJSA.Endorse and agree to abide by the NWJSA Member Protection Policy (MPP) and the Child Safe Environment Policy, and ensure that all players, parents/caregivers, officers and volunteers also adhere to these policiesAgree to implement and adhere to the steps outlined in the (MPP) document to ensure that the above named School is compliant.
Principal Name*
First NameLast Name
Principal E-mail*
example@example.com
Appointment of Delegate
As Principal, I hereby appoint the following person to act as Delegate in all matters connected with the School and the NWJSA. I acknowledge that if a Delegate is not appointed, I will act as Delegate until such time that another person is appointed. I understand that it is the responsibility of the appointed School Delegate to attend NWJSA meetings and forward all relevant information from NWJSA to the school, coaches, parents/caregivers and players. Also, I acknowledge that the appointed School Delegate will represent the School and vote on behalf of the School at General Meetings of the NWJSA.
Appointed - Delegate*
First NameLast Name
Delegate Mobile Number*
Delegate E-mail*
Principal Signature
Clear
Delegate Signature*
Clear
Date
DayMonthYear
Date
Date*
DayMonthYear
Date
Should be Empty: