This form must be completed by any player seeking a Short Term Temporary Clearance from Brisbane Hockey Association to play for another Association at a State Championships. Questions must be answered truthfully.

By filling this out it does not guarantee your clearance. Your request will be given to the Director of Representative Hockey for consideration.

Players are not permitted to approach other Associations, Associations will contact BHA.

To request clearance to play representative hockey for another association, you must meet one or more of the following criteria. These reasons include, but are not limited to:

1. Not selected/required by Primary Association
2. Represent your Association of origin
3. Dually registered playing for the Secondary Association
4. Primary association not participating in Championship
5. Umpiring/Technical Official for another Association