2025 Age Exemption Application Form

Applications from club administrators for age exemptions.

Prior to application club administrators should check to see if their request falls within the parameters of exemption as per the Age Exemption Process document.

Enter your email address*

<p>This form is to be completed by a Club Administrator/Coach requesting an Age Exemption for a performer in line with the <a href="https://cdn.revolutionise.com.au/cups/calivic/files/b3bpwjgxep1laxgm.pdf" target="_blank" rel="noopener">2025 Age Exemption Process</a> </p>
<p>Please fill in one form per performer. </p>

Club*

Club Administrator Name*

Club Administrator Email*

Performer Full Name*

Performer Date of Birth*

Reason for request*

Disability/Medical circumstance

No age section for performer

Performer needed to complete numbers in age section

Personal circumstance (NB. limited consideration)

Details of request*

Please provide further details of your request

Supporting Documentation (if relevant)

Eg. medical documentation. Please note for disability/medical circumstances supporting documentation is required

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