BELMONT OASIS LEISURE CENTRE
www.belmontoasis.com.au
JUNIOR SOCCER TEAM NOMINATION FORM
Term 4 2011
Season commences Wed 19TH October
Season concludes Wed 7th December
No games during school holidays
Nominations Close – 12th October
Nominations that are not signed, dated and accompanied by the
nomination fee will be rejected.
This is an application to join one of the sports competitions at the Belmont Oasis
Leisure Centre and no guarantee is given that this application will be successful.
The Sports Department reserves the right to accept or reject any nomination and
to delete any team from the competition during the season due to misconduct,
etc.
Cnr Abernethy and Alexander Rds, BELMONT, 6104
Phone: (08) 9277 1622 Fax: (08) 9277 1340
GAME TIME AVALIABILITY
All teams are expected to play in all time slots over the season. If your team is
unable to play at a designated time you are required to fill out a Team Request
Form. Management reserves the right to add and change any game times when
necessary.
GAMES PAYMENTS AND DUTIES
Team game fees are to be paid at front reception prior to your game beginning. A
receipt will then be issued and is required to be handed to the umpire. The game will
not start until both receipts have been handed to the umpire.
TEAM UNIFORM
Three (3) weeks grace period will be allowed after the commencement of the season
or if a team enters after.
All players in the team must be wearing the same colour top. Bibs will be supplied by
the centre.
FORFEITS
The clock will start at the designated game time, and if any team is not ready to play
before the end of the first quarter the game will be called a forfeit.
When a team cannot adhere to the fixtured game time the game will be called a
forfeit and charged a forfeit fine. If a team forfeits twice they will receive a warning.
Third forfeit and management reserves the right to withdraw the team and replace
them with anew team from the waiting list. A withdrawal fine will be issued.
Charges are as follows:
$30 per forfeit
OUTSTANDING FEES
All team nominations must be accompanied with a nomination fee, or paid at the first
game. Forfeit fines must be paid within a month of the forfeited game.
WITHDRAWAL OF TEAM
A $30 withdrawal fine will be awarded when withdrawing from the competition. All
outstanding monies are also required to be paid.
UMPIRES
The centre will supply one umpire per game.
Belmont Oasis Leisure Centre
Cnr Abernethy & Alexander Rd’s Belmont Oasis
Tel: 9277 1622 Fax: 9277 1340
[email protected]
JUNIOR SOCCER - TEAM NOMINATION FORM
Team Name:
___________________________________________________________
___
First Team Contact (parent/guardian)
Name:
_____________________________________________________________________
__________
Address:
_____________________________________________________________________
________
Phone: (Home) _________________ (Work) ____________________ (Mobile)
____________________
Email Address:
_____________________________________________________________________
___
Please provide an email address for all communication
NOMINATION AND GAME FEES
Team nominations will not be accepted without payment of a nomination fee.
All fees are stated below:
Nomination Fee: $20 per team
Game Fee: $30 per game
*Management reserves the right to modify game fees with appropriate notice
Forfeit fines:
 $30 per forfeit
Withdrawal:
 $30 withdrawal fee if the team leaves the competition before the end of the
season.
COMPETITION (Please tick)
Wed League 1: U7’s
Wed League 2: U10’s
Wed League 3: U13’s
PLAYERS TEAM LIST
Please list all team members that will be playing through the season. This is the
teams’ main list sheet, any additional players must be added to the score sheet on
the day of your games.
Please PRINT clearly.
PLAYERS NAME
PH (Home)
PH (Mobile)
PLEASE NOTE

Players are responsible for arranging their own insurance cover

This is an application to join one of the sports competitions at the Belmont Oasis Leisure Centre and no
guarantee is given that this application will be successful. Where teams can not be included they will be
notified and a refund of the nomination fee will be sent to the team contact within the first month of the
fixture

Feedback provides the Belmont Oasis Leisure Centre with the ability to maintain and assess the quality of
service the centre provides. Please contact the Junior Development Officer if you wish to provide
feedback.
DISCLAIMER

Use of the facility is at your risk

You will be held responsible for your own property and safety, and the property and safety of minors and
those within your care

All children under the age of 13 must be accompanied and supervised by a responsible adult

Please read the instructions regarding use of equipment in the area you will be using and ensure you have
understood

Belmont Oasis Leisure Centre will not be responsible for any loss, damage, or injury to you and those in
your care which arises from the negligence of its servants, agents, independent contractors, voluntary
workers and other users of the facility.

In the event that it becomes necessary to enlist the services of a third party to collect monies on behalf of
Belmont Oasis Leisure Centre, it is understood that the costs associated with the collection will be charged
to the team contact.
DECLARATION
On behalf of the team named on this form I declare that all children listed above will participate in all matches
programmed for the duration of this season and undertake to honour all forfeit fines, withdrawal fees and
suspensions that may be imposed on this team by the management of the Belmont Oasis Leisure Centre. I also
acknowledge that I have read the above conditions and explained the conditions of use to all members of my team:
Signature (Team contact):__________________________________
Name:____________________________________
Date: _____/_____/_____