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2012

WOW! RECEIVE ALL THIS IN YOUR 2012 NAB AFL AUSKICK PACK

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6350 Auskick Form 2012B_d4.indd 1 1/12/11 3:37 PM Who will be How to Register NAB AFL Auskick 2012 the 2012 NAB The easiest way for you to register AFL Auskicker for season 2012 is online. Just follow NAB AFL Auskick is the country were involved in the of the Year? these very simple steps: Australian Football League’s NAB AFL Auskick program and 1. Visit aflauskick.com.au The search is on again in key introductory program we would love your family 2. Click on ‘Register Here’ – 2012 for the NAB AFL Auskicker located on the landing page. for primary school-aged boys to join the team. of the Year. We are looking 3. New participants: if you have not taken and girls and their families. for the Auskicker who best Importantly, as a parent part in NAB AFL Auskick in previous During our weekly coaching demonstrates the spirit of you can get involved as years, click on the ‘New Participant’ program your child will learn the game – commitment, icon and follow the simple steps. a volunteer the skills of the game through enthusiasm, teamwork 4. Re-registration: for children who and watch first- appropriately modified and passion. Twenty-two participated in the program in 2011, hand as your activities where the emphasis nominees for the award will click on the ‘Re-registration’ icon and child enjoys receive a money-can’t-buy is on fun and having a go. follow the steps. footy in 2012 Toyota AFL Grand Final 5. Don’t forget to print your registration Enrolling your child in a fun and experience in Melbourne, form, get Mum or Dad to sign it and NAB AFL Auskick is the ideal relaxed plus the overall winner take it to your local centre. Please note: will receive $5000 in a NAB way to get them involved in a environment. your online registration form will contain Smart Junior Saver Account great program, where learning your identification/registration number. Joel and AFL star Joel Selwood 6. Some centres will be accepting skills, making new friends and Selwood as a footy mentor in 2013. online payment, so check it out being part of a team is what NAB Enter your son or daughter when you register online. it’s all about. Last year, more ambassador today at aflauskick.com.au. It’s that easy! Alternatively, you can than 167,000 kids across the AFL Authorisation Code: GFAFL12/03 complete this registration form and take it to your local NAB AFL Auskick centre.

Registration Form A copy of this form should be retained by the centre coordinator NAB AFL Auskick centre Today’s date / / 1. Auskick information 4. General information Was the participant registered in NAB AFL Auskick in2011 ? Yes No AFL club supported If yes, has their address, school or Yes No Member? Yes No the AFL club they support changed? How many AFL games would they attend per season? 2. Participant information How often do they watch AFL games on TV? Date of birth / / dd/mm/yyyy M F Will your child play AFL in another competition? Yes No Given name If yes, which AFL competition? Club School Both Surname 5. Communications Street address Suburb Would you like to receive information and Yes No promotions related to the NAB AFL Auskick State/Territory Postcode program or from the AFL, AFL corporate partners, Email the AFL club you support or your local junior club/s? School attended 6. Medical School suburb Grade Does your child suffer from any illness or disability? Yes No Was the participant’s father/mother born overseas? Yes No (If yes, please provide details to coordinator) If yes, which country? Does your child suffer from any allergy Yes No Language other than English spoken at home or is he/she allergic to any medication? Aboriginal/Torres Strait Islander? Yes No (If yes, please provide details to coordinator) In an emergency, do you authorise the NAB Yes No 3. Parent/guardian contact details AFL Auskick centre coordinator to arrange any Given name necessary medical treatment for your child where prior notification has not been possible? Surname Email 7. Signature Telephone I hereby confirm that the information provided by me herein Can you assist with any of the following? is true and correct. By signing this form I agree to the AFL Auskick Terms of Participation (a copy of which is available Coaching Administration First aid at aflauskick.com.au on request) General helper Umpiring Are you interested in being a NAB Centre Champion?* Yes No Signed * A NAB Centre Champion will be the key NAB contact for all communications about NAB’s Auskick competitions. Your role will be to promote the competitions to parents and participants at your Auskick centre.

Are you an employee of NAB? Yes No Are you a NAB Customer? Yes No Parent/guardian

Receipt of payment NAB AFL Auskick centre Given name Surname

Amount received $ (incl. GST) Cash Cheque Signed NAB AFL Auskick centre coordinator

The AFL takes care to ensure the confidentiality of the information provided on this application form and handles the information in accordance with the 10 national privacy principles set out in the Privacy Act.

6350 Auskick Form 2012B_d4.indd 2 1/12/11 3:37 PM