Winter Single Player Application Form

Welcome!

We are taking Individual Player applications for our 2022 Winter Competition.

Our 2022 Winter competition will commence in May, 2022 with our finals towards the end of July 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 Monday 25th April 2022. First in, will be guaranteed a spot in the competition, so Don't Miss Out!

Games are played with seven (7) players on the field at any one time and unlimited reserves.

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

No player is covered by Insurance!

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

Winter Individual Competition

MIXED or MENS

Heffron Park
Monday & Wednesday evenings

Entry Fees

$95 to enter one competition/night

$125 to enter two or more competitions/nights

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

Please have yourself registered and paid in full by:

Monday 25th April 2022

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 - $95

Two or More Competitions/Nights - $125

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

Heffron Park Competitions: * 🛈

Monday - MIXED - from 6:30pm

Monday - MENS - from 7:00pm

Wednesday - MIXED - from 6:30pm

Wednesday - MENS - from 7:00pm

Personal Information

Full Name: * 🛈

Email * 🛈

Contact Number: * 🛈

Emergency Contact Full Name: * 🛈

Emergency Contact Email * 🛈

Emergency Contact Number: * 🛈

T-shirt / Singlet size? *

Is there any particular people you would like to join in a team with?

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

Yes

Maybe

Payment Details:

Payments to be made via Bank Transfer to the below account on or before Monday 25th April 2022 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 (if required).

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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