Summer Individual Player Application Form

Welcome!

We are taking Individual Player applications for our 2021/22 Summer Competition.

With the recent announcement from NSW Health our intention is to start the competition in October for Fully Vaccinated and Medical Exempt players, from 1 December all players will be welcomed based on Public Health Orders.

We are scheduled to commence the competition from Monday 25th October 2021 (as normal) with our Finals towards the end of February beginning of March, 2022.

To reserve a place in one of our Queens Park Teams in this year's comp, we are asking for you to submit the online application and make payment in full by Friday 15th October 2021. First in, will be guaranteed a spot in the competition, so Don't Miss Out!

There will be (approx) 4-5 week break over the Christmas period, no games will be played during the break.

Games are played with seven (7) players on the field at any one time, due to COVID we ask that you have no more than 15 players per team.

All players must adhere to the rules and be in uniform by round four (4).

No player is covered by Insurance!

Insurance is each team and player’s own responsibility and/or choice.

Summer Competitions

MENS	MIXED

Queens Park
Monday & Tuesday

Entry Fees

$100 to enter one competition per night

Or

$150 to enter two or more competitions

Fees cover the full season and a team uniform (t-shirt or singlet)

Please have yourself registered and paid in full by:

Friday 15th October 2021

Opportunity

Referees Wanted!

Think you or your players have what it takes to referee!?

Get in touch with us for further details on 0409 307 607 or queensparktouch@hotmail.com

Competition Selection

Please select at least one response from the competitions below.

#Competitions/Nights: * 🛈

One Competition/Night - $100

Two or More Competitions/Nights - $150

If you want to play in multiple competitions then please select all relevant checkboxes.

Queens Park Competitions:
* 🛈

Monday - MIXED - 6:30pm

Tuesday - MENS - 6:00pm

Tuesday - MIXED - 6:30pm

MENS :	No more than 7 players must be on the field at any one time.
MIXED :	No more than 4 male players and 3 registered female players must be on the field at any one time, with the exception of 1 lady must be on the field to start a game.

Personal Information

Full Name: * 🛈

Email * 🛈

Contact Number: * 🛈

Emergency Contact Full Name: * 🛈

Emergency Contact Email * 🛈

Emergency Contact Number: * 🛈

Uniform Preference: *

T-shirt / Singlet size? *

Are there any individuals you would like to join in a team with, please provide their name(s):

Would you be interested in refereeing (paid per game)? *

Yes

Maybe

No

COVID-19 Vaccination Status:

Please provide your COVID-19 Vaccination Status: *

Payment Details:

Payments to be made via Bank Transfer to the below account on or before Friday 15th October 2021 or email queensparktouch@hotmail.com for a different payment option.

Account Name

BSB

Account Number

Reference / Description

Declaration of consent:

I agree to comply with and abide by the rules of Queens Park Touch Football Association, including adherence to the COVID Safety Plan.

I am aware of the requirements relating to insurance (No player is covered by Insurance! Insurance, it is each player’s own choice and responsibility).

All our players, officials and referees are human.

They volunteer their time and without them we wouldn't have a Competition.

Please treat everyone with respect!

Name: * 🛈

Signature: *

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	Contact Us:
	m: 0409 307 607
	queensparktouch@hotmail.com
	www.queensparktouch.com.au
	www.facebook.com/queensparktouch/
	www.instagram.com/queensparktouch/