Volleyball Queensland Club Release

Club Release and/or Join Application
Request a release from your existing Club and/or request membership to a new Club.

Note: The person submitting this form must be the VQ member requesting this action or the parent/guardian of the member if under 18 years.
No third party can submit this form on behalf of the member.
Today is

Day Month Year
Date
at
Hour Minutes AM/PM Option
022515

Important: VQ can only record your registration with one and only one of it's Clubs (including "other") for representation purposes. If you wish to change your club (from a previous year's registration or in the future) you will need to complete the VQ Club Release/Join process.

Please select a club from at least one of the following two dropdowns.
Existing Club
New Club
Other
Othercode
Team Name
From Club Email
To Club Email
VQ's web page showing methods of contact for each VQ Affiliated Club.

Hidden separator to keep fields together
Given Name *
Preferred Given
Middle Name(s)
Family Name *
Nee
Gender *

Male Female
VQID
If known
Sexcode

Hidden separator to keep fields together
Date of Birth *

Day Month Year
Age
Age Category
E-mail Address *

Confirmation Email example@example.com
Phone number *
10 digits only
Notes

Please provide any additional information that may be relevant to this application. 0/152
Please supply a photo or scan of an official
form of identification. e.g. driver's licence or
student Id. As a png or jpg.
ID Photo *

Browse Files
.png .jpg only Cancel of

Parent Section - Hidden separator to keep fields together
Members under 18 years Please fill in Parent/Guardian details
Parent/Guardian Name *

P/G Given Name P/G Family Name
Parent/Guardian Phone Number *
Parent/Guardian E-mail Address *

Confirmation Email example@example.com
Parent/Guardian Authorisation *

I agree with this transfer request.

End Parent Section - Hidden separator to keep fields together
Complete Email Address
example@example.com

Member Declaration
I declare I am the member stated as making this application or if under the age of 18 years I am the parent/guardian of the member in this application. That all the information I have provided is complete and correct and submit this application in good faith.

Member Declaration *

I agree to the above declaration.

Summary of Input
From Club	Name	Age	Phone
{existingClub}	{givenName} {familyName}	{age}	{phoneNum}
To Club	Email
{newClub}	{completeEmail}

Blank
office use only
After clicking Submit, please wait for the Thank You page

Submit Section
DBemail
example@example.com
Should be Empty:

Club Release and/or Join Application

Members under 18 years Please fill in Parent/Guardian details