Fiona McBurney Match Day Experience

The Fiona McBurney Match Day Experience aims to connect sport and disability by providing a unique experience for participants to undertake an official guest AFL trainer role for the AFL umpires on match day.

If you love footy and would like the chance to be on the field at Marvel Stadium and meet players and umpires, apply today!

Participant information

Participant's name *

Date of birth (must be 18 years+ to be eligible to participate) *

Participant representative contact information

Participant representative name *

Relationship to the participant *

Email address *

Phone number *

AFL matches

About the participant

Does the participant fulfill the following criteria? (Yes/ No) *

YesNo

Does the participant have Down syndrome?

YesNo

Is the participant 18 years+?

YesNo

Is the participant able to follow instructions?

YesNo

Is the participant comfortable sitting and watching the game from the bench with the trainers and umpires without a parent/ carer?

YesNo

If the participant is selected for a game, would they be available to attend an AFL umpire training session on 24th February in Melbourne? (Exact location TBC) *

YesNo

If the participant is selected for a game, do they consent to having their photograph taken and used for promotional purposes by DSV, AFL Umpire Association and/or the AFL? *

YesNo

What is the participant's favourite AFL team?

Has the participant attended a Fiona McBurney Match Day experience before? *

YesNo

Is there anything else we should know about the participant or their application?

Application signature

I would like to participate in the Fiona McBurney Match Day Experience.

Signature of participant or their representative *

Draw signature|Type signatureClear

Name of person signing *