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33RD QA ALL SCHOOLS CROSS COUNTRY
CHAMPIONSHIPS
Saturday 9 May 2015 – Kedron State High School
ENTRY FEE:
$12.00 per student
TAX INVOICE
ABN: 11 010 706 751
ENTRIES CLOSE:
Tuesday 5 May 2015 at 5:00pm
Please contact Queensland Athletics if your school may have difficulty meeting the closing date.
Late entries are also accepted on the day of the championships up until one (1) hour before the scheduled
start time of each event. A $20.00 fee per student will apply to all late entries.
SCHOOL DETAILS
School Name
Postal Address
Suburb
Postcode
SCHOOL CONTACT PERSON
Name
Position
Phone
Mobile
E-mail
1.
2.
3.
4.
I am authorised to submit this entry form on behalf of the school and have received any relevant permission from the parents/guardians of the
students entered.
All students entered will be made aware that they must abide by the competition rules and take direction from Queensland Athletics officials during
the event.
The school, the students entered and their parents/guardians are aware that action photography may be taken by the official event photographer
and names/images of students may be used by Queensland Athletics and images displayed by the official event photographer.
By participating in the Championships, non-members will automatically become a direct member of Queensland Athletics and will be eligible to
compete as a member in further QA cross country, road and winter track & field events for the remainder of the 2015 QA registration year.
Signature: _______________________________________________________ Date: __________________
ENTRIES:
Students @ $12.00 each
AMOUNT DUE:
$
List students on next page
 List entrants on the form provided (see next page). Please write clearly to ensure all students are correctly
entered into their event. If there is insufficient room for all entries, please make additional copies and
continue. For large school teams, an Excel Spreadsheet Template is available to easily submit entries
 Entry fees should ideally be received before the day of the championships where possible. Please contact
Queensland Athletics if you require a separate invoice or if your school may have difficulty meeting the
closing date. Fees are inclusive of GST.
SUBMIT YOUR ENTRY:
Mail:
Scan & E-mail:
Fax:
In Person:
Queensland Athletics, PO Box 249, Sunnybank Qld 4109
info@qldathletics.org.au
(07) 3349 6218
Level 3, Qld Sport & Athletics Centre, Kessels Road, Nathan
2015 QA ALL SCHOOLS CROSS COUNTRY CHAMPIONSHIPS – SCHOOL GROUP ENTRY FORM
PAGE 2 OF 2
School Name
PLEASE WRITE CLEARLY!
If there is insufficient room for all entries, please make additional copies and continue.
NOTE: For large school teams, an Excel Spreadsheet Template is available to easily submit entries.
GENDER
SURNAME
FIRST NAME
DATE OF BIRTH
Students are automatically placed into the correct event according to their year of birth (see timetable).
NOTE: Event entry age is taken to be as at 31 December 2015.
PLEASE INDICATE IF ANY STUDENTS ARE ENTERING THE ATHLETE WITH A DISABILITY (AWD) EVENTS.