SATURDAY 25

th

APRIL 2015

OPEN INTERNATIONAL
ENGLAND DODGEBALL TRIAL
Affiliated to

Affiliated to UK Dodgeball Association the National Governing Body for Dodgeball

England Lions Power . Precision . Pride www.englandlionsdodgeball.co.uk
england.lions@ukdba.org

For more information contact:

england.lions@ukdba.org
Who is the trial for?
Players aged 16 and above who are of English nationality and are passionate about
representing their country at dodgeball. For player eligibility regulations see:
http://www.ukdba.org/#/international/4544109252
Talent Identification Scouts will be looking for the best players to put forward for a
second trial, which will consist of integration into a training session with current
members of the academy squads.
Why England Lions?
England Lions has made a promise to select and develop the very best English players
into a world-beating side. We are the reigning European Champions in all
competitions and we aim to stay there. With the very best coaches and support
available, we aim to develop a squad ready to take on any nation at any time.
Where will the trials be held?
The trials will be held at:
Munrow Sports Centre, University of Birmingham, Edgbaston Campus, B15
2TT
The university has its own train station a 5 minute walk away from the sports centre
(University Birmingham), and ample parking on site. More information about where to
go on arrival will be sent nearer the trial.
The trial itself will take place across two different halls. There is limited viewing space
and since this is only for one hall there is no guarantee that any guests would be able
to watch/ support particular trialists.
What will happen on the day?
The trial will involve fitness tests, scenarios and game play. Registration will be at
12pm, with trials finishing no later than 4pm.
What do I need to bring to the day?
1. Identification for eligibility- preferably in the form of a British passport or driving
license
2. Your candidate no. and safety pins (your candidate number will be sent to you
to print on receipt of your application)
When is the second trial?
If successful, you will be invited to a closed trial on Sunday 24th May, 2.30pm-6pm at
Enderby Leisure Centre, Mill Lane, Enderby, Leicestershire, LE19 4LX.
How do I apply?
Complete the form below and return to England.lions@ukdba.org before midnight on
the 13th April 2015. The form should be fairly straightforward to edit and a typed
signature will suffice. Those who do not submit an application form by this date will
not be able to attend the trials.
Affiliated to UK Dodgeball Association the National Governing Body for Dodgeball
England Lions Power . Precision . Pride www.englandlionsdodgeball.co.uk
england.lions@ukdba.org

A 5 trialling fee will be required on the day of trials in order to cover the costs of the
event. More details will be provided once your application has been received and
processed.
You will be expected to wear appropriate sports clothing and footwear that doesn't
cause any threat of injury to yourselves or others. You may wish to bring food and
drink as lunch will NOT be provided. Dodgeballs and all other equipment will be
provided on the day.
Personal possessions will be kept at your own risk to one side of the hall that you are
trialling in, and may not always be accessible.

Affiliated to UK Dodgeball Association the National Governing Body for Dodgeball

England Lions Power . Precision . Pride www.englandlionsdodgeball.co.uk
england.lions@ukdba.org

TRIALIST DETAILS
Players Full Name:
Trialling/eligible for (please circle all that apply)
Mens Senior

Womens Senior

U21 (Under 21 on 30/06/2015)

Date of Birth:
Address:
Post Code:
Tel no.:
Mob no.:
Email:
Team you currently play for:
Team you will be playing for during 2015/16 season:
Positions/Roles (please circle all that apply)
Thrower

Catcher

Retriever

Blocker

Runner

How long have you been playing Dodgeball?

Detail below any achievements in Dodgeball so far (e.g. University
Championships 2014 Gold):

I declare that the above information is accurate and honest; if found to be

incorrect I accept this could ultimately result in sacrificing any offer of a
place in the England Lions Academy.
Signed:

Date :

Affiliated to UK Dodgeball Association the National Governing Body for Dodgeball

England Lions Power . Precision . Pride www.englandlionsdodgeball.co.uk
england.lions@ukdba.org

FITNESS DECLARATION AND MEDICAL DETAILS

By signing this form I declare that I am the player named above and that I
am fully fit to participate in a training/ trialling period with England Lions
Dodgeball. In the event of me sustaining any injury whilst playing or training
with England Lions Dodgeball during my trial period, I agree that England
Lions Dodgeball are in no way liable.
Does the trialist:
Have a medical condition requiring medical treatment or medication? YES
Have an allergy to certain medications? YES

NO

NO

Is he/she able to administer his/her own medication?

YES

NO

Please give details of medical condition/treatments, allergies to medications, or any

other medical issues to bring to the coaching teams attention below:

Has he/she been in contact with any contagious or infectious diseases or suffered
from anything
in the last four weeks that may become contagious or infectious?
YES

NO

If yes, give details:

Does he/she have any special dietary requirements?

If yes, give details:

EMERGENCY CONTACT INFORMATION

MAIN

ALTERNATIVE

FAMILY DOCTOR DETAILS

Name:
Affiliated to UK Dodgeball Association the National Governing Body for Dodgeball
England Lions Power . Precision . Pride www.englandlionsdodgeball.co.uk
england.lions@ukdba.org

Address:
BEFORE SIGNING THIS FORM it is important to understand that whilst the coaching
staff will take all reasonable care of the player, neither they, nor England Lions
Dodgeball, can necessarily be held liable with respect to loss of or damage to property
or injury suffered by the person arising out of the trial, unless such loss, damage or
injury results from the negligence of England Lions Dodgeball and its official
volunteers.
Please be aware that any information provided by you will be held by
England Lions Dodgeball on its computer databases and used for
administering your involvement in England Dodgeball. Please let us know if
you do not wish us to contact you via email or telephone in order to promote
the sport.

Signed:

Date

By parent / guardian if under age of 18:

Thank you for taking the time to fill out this application.
JESS GOSHAWK
England Manager

SPORTICUS is England Lions Dodgeballs Official

Ball Sponsor; they sell official UKDBA approved
dodgeballs at low prices and can bespoke them to
meet your needs. Mention us when ordering and
get your dodgeballs at a discount rate.

Affiliated to UK Dodgeball Association the National Governing Body for Dodgeball

England Lions Power . Precision . Pride www.englandlionsdodgeball.co.uk
england.lions@ukdba.org