This form is required for players seeking an exemption from participating in Brisbane Hockey Representative Trials or requesting to trial outside their designated age group. Applicants must provide detailed reasons outlining their unavailability for the scheduled selection event or their request to trial in a different age group. 

Requests must be submitted at least seven (7) days prior to the start of the respective trials. The BHA Representative Director will review all submissions and forward approved exemptions to the selection panel for consideration. 

For exemptions due to medical or injury reasons, a medical certificate detailing the injury and estimated recovery time must be submitted to Brisbane Hockey before the commencement of the trials.