EmailMe Form - Five a Side team nomination form

Team Status *

Returning Team

New Team

Team Name (subject to availability) *

Managers Details (This will be the main contact for correspondence for this team) *

First Last

Email *

Phone *

Preferred Playing Night *

All players must be CURRENT 2021 registered 5 a side players to participate in any 5 a side season competition. TEAM PLAYER DETAILS:

	First Name	Surname	D.O.B	Email	Phone number	FFA number	Club played for in Winter 2020
Player 1
Player 2
Player 3
Player 4
Player 5
Player 6
Player 7
Player 8
Player 9
Player 10

5 A Side Player registration is $120 per player and must be PAID IN FULL AS A TEAM, prior to season start. There will be no other match fees charged per game. *

Direct Bank Transfer : IMB BSB:641-800 ACCOUNT NO : 200744102 REF : TEAM NAME

Credit card via phone 0242856929.

In Person at the FSC Office

Payment must be made in full prior to COB Friday 22 January in order to secure your team's position in the competition.