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Details marked with
*
are mandatory - if information is not available please type in NA
Only team names that are in good taste will be accepted
TEAM OR GROUP DETAILS:
*
TEAM or GROUP NAME:
NUMBER OF PLAYERS:
(We will either top up your group or place your group into an excising team)
Men
Women
*
PRIMARY TEAM CONTACT:
CONTACT NAME:
ADDRESS:
SUBURB:
POST CODE:
HOME PHONE NUMBER:
WORK PHONE NUMBER:
MOBILE NUMBER:
EMAIL ADDRESS:
SECONDARY TEAM CONTACT DETAILS:
CONTACT NAME:
ADDRESS:
SUBURB:
POST CODE:
HOME PHONE NUMBER:
WORK PHONE NUMBER:
MOBILE NUMBER:
EMAIL ADDRESS:
*
Declaration and Privacy:
We hereby agree to be solely responsible for all cost for ourself to play for the season. Further more, we will abide by all of the rules and regulations* set down by Pure Touchfootball Association for the entire length of the season. (*
see Rules & Regulations
)
Privacy: I agree that the contact details disclosed above can be used by Pure Touchfootball to contact me regarding competitions for this and future seasons. If I nominate a group or individual the contact details can be provided to the manager of the team the player are placed in. Information will not be disclosed to third parties.
*
VENUE AND NIGHT SELECTION:
Monday
Yeronga
Wednesday
Yeronga
*
GRADE SELECTION:
MEN'S
MIXED
WOMEN'S
Please conform if your team has ever played in an administered touch football competition before:
-
Yes
No
If so may we ask which competition?
OTHER RELEVANT INFORMATION:
*
PAYMENT SELECTION:
I will post a cheque or money order to GPO Box 3178 Brisbane Q 4001
I will pay by Credit Card by contacting the office on 3879 2192
