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All Fields in the sections below marked with * are mandatory - if no information is available please type NA
Also only team names that are in good taste will be accepted by the Management Committee

 

*Team or Group Details:
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:
CONTACT NAME:
ADDRESS:
SUBURB:
POST CODE:
HOME PHONE NUMBER:
WORK PHONE NUMBER:
MOBILE NUMBER:
EMAIL ADDRESS:

*Declaration and Privacy:

Agreement

 

We hereby agree to be solely responsible for all cost for yourself 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. 

 

*NIGHT AND VENUE SELECTION:

Please Choose Which Night you wish to play.

Monday Nights will be a 6 a side competition,

Wednesday's will remain a 7 a side competition.


*DIVISION SELECTION:

Please choose which Division your group falls into :-

(We require @ least 4 teams in a particular division to play).

Mixed Masters (Wednesday Only)

Please conform if your team has ever played in an administered touch football competition before:
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 or using the online Payment Form

I will pay via Direct Deposit using Internet Banking or branch deposit


 

 

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