Our Cardiad Defibrillators located at our Harold West and Roselea Club Houses are supplied by Medirent. Please note that while they are in a glass cabinet that has a lock, they are always left unlocked.  Their use was demonstrated by the supplier at one of our Coach and Manager meeting. If you would like to receive another demonstration on their usage, please do not hesitate to contact the club and we will arrange another session.


We've also included two useful links for you in using the devices.


AED Lifestation instructions


AED Lifestation instructional video


Notify your Vice President as soon as possible, see the committee contacts below


Complete the Roselea Injury Claim Form and forward it to your VP

Follow the steps below, click here for more info or to lodge a claim.

Below is information on how to make a claim under the Sports Injury policy. If you wish to make a claim or notify an incident for General Liability, Professional Indemnity or Management Liability, please contact Gow-Gates immediately.


Sports Injury Claims

Steps to follow:

1.     Obtain a claim form

2.     Complete the claim form

3.     Lodge the claim form

4.     Lodge additional documentation as required

All the above steps can be completed online through the online claims portal. In order to submit your claim online, please click here

Step 1: Obtain a Claim Form

A claim form can be obtained via any of the below methods:

Step 2: Complete the Claim Form

The insured person is to fully complete all sections of the claim form. In addition, the following people will need to complete their relevant sections:

  • The Physician’s Statement, will need to be completed by the main doctor, surgeon or dentist

  • If you are claiming for loss of income, you will need to have your employer complete the Employer’s Statement.

  • The club president, treasurer or secretary will need to complete and sign the Club Report and the your Association will need to sign the Association Declaration of the claim form, having verified all the details completed in the form.

Step 3: Lodge the Claim Form

Send the completed claim form to Gow-Gates within 120 days from the date of injury via:, or

Gow-Gates Insurance Brokers
GPO Box 4731

The claim form will be acknowledged within 10 days by Gow-Gates. This acknowledgement will include a unique claim number which can be used when lodging additional documentation and when using the Online Claims Tracking Facility

Step 4: Submit additional paperwork

In order to claim, the following documentation will/may be required in addition to the claim form.

  • Receipts for paid Non-Medicare Medical and/or Physiotherapy  Expenses

  • Health Fund rebate statements

  • Doctors Certificates confirming the period of incapacitation

  • Proof of Earnings documentation

  • Tax File Number declaration

  • Any other documentation requested.

Don’t wait for the above documentation before submitting the claim form to Sportscover as this delays the claims process and means that your claim payment will be slower.



Football NSW Claim Form (PDF)
Fustal Claim Form (PDF)

Reporting an Injury - Process to Follow
Roselea Injury Claim Form


For more information on making a claim please click here



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Roselea Football club

Harold West Reserve

Moseley Street - Carlingford