NOMINATE FOR MEMBERSHIP – Online
Please complete your ‘Membership Nomination’ details below
and we will respond to you as quickly as possible.
Thank you.

ALL (TEXT) FIELDS, BUTTON SELECTIONS AND CHECKBOXES ARE REQUIRED

    Enter your full street address

    Preferred playing Municipality

    Best Contact Number

    Please provide an Emergency CONTACT PERSON

    Please provide an Emergency CONTACT NUMBER

    Please select your age bracket
    - 4950 - 5960 - 6970 - 7980 +

    Have you played competitive Soccer before
    yes (a lot)yes (a little)not at all

    I have read and fully acknowledge the 'Agreement Of Understanding for Membership and Participation with Walking Football Tasmania Inc'

    I agrree to be sent a request for the $10 Annual Membership Fee and will make that payment within 1 week of request. I also acknowledge my Membership will be due for renewal the date after I join of the following year and (if renewing) will be paid within 7 days of expiry.

    Please accept the 'Terms | Privacy' for this site (To view click here)

    Please prove you are human by selecting the star.

    Agreement Of Understanding for Membership and Participation with Walking Football Tasmania Inc.

    In consideration of Walking Football Tasmania Inc. (Walking Football) accepting my application for Membership and Participation,
    I acknowledge, understand and agree that:

    Walking Football for the purposes of this agreement means Walking Football Tasmania Inc and includes, where the context so permits directors, officers, members, servants or agents.

    Participating in this Walking Football program/activity carries with it the inherent risk of physical injury, including serious injury such as permanent disability, paralysis and even death. These risks arise from the activity which can result in falls, collisions and unintended body contact. The actions of other participants can be unpredictable. I acknowledge and understand the risks and I participate entirely at my own risk.

    I am medically and physically fit and able to participate in the Walking Football Activity and I will immediately notify Walking Football of any change to my fitness and ability to participate. I understand and accept that Walking Football will continue to rely on this declaration as evidence of my ongoing fitness and ability to participate.

    I will at all times comply with the instructions and safety procedures of Walking Football.

    If required, Walking Football will arrange medical or hospital treatment (including ambulance transportation) for me. I authorise such actions being taken by Walking Football and agree to meet all costs associated with such action and indemnify Walking Football for any outlay made for my benefit.

    I acknowledge and agree Walking Football may in good judgement record part of a playing session for promotional purposes and I release and indemnify Walking Football and its photographers from any claims for remuneration associated with any form of damage, foreseen or unforeseen, associated with image use. I also understand I have the right to revoke permission for use.

    I have read and fully understand these membership and participation terms and agree to release and indemnify Walking Football Tasmania from liability for any injury or other losses I incur or cause, including acts of negligence, to the fullest extent permitted by law.

    By selecting the checkbox I acknowledge I have read and understand all of the above and accept this Agreement.