MUSTANG CUP
NOMINATION FORM
SUNDAY 11th June 2017
LOCATION: WHITES HILL RESERVE, BOUNDARY RD, CAMP HILL, QLD
Team Name:
Affiliate Name:
Tour Manager/Coordinator:
Address:
Post Code:
Phone:
Fax:
Mobile:
Email:
Nominations Close: COB Sunday 28th May 2017.
$210 per team
(gst inc)
BMTA will supply all Referees
DECLARATION
I hereby nominate the ____________________________ team in the Mustang Cup. I acknowledge that I have read
the conditions of nomination and Conditions of Entry booklet, and agree to accept those conditions on behalf of
my team. I also acknowledge that the team will abide by the Competition Rules & Procedures and accept all
decisions made by the Tournament Committee in relation to those Competition Rules and Procedures as final.
Signature
_____________________________________ (Must be Team Contact)
Printed Name
_____________________________________
Date
/
/
Division
No.
Referee
(Yes/No)
Cost
$210.00
Per team
Boys 10 Years & Under (Born 2007 or after)
Girls 10 Years & Under (Born 2007 or after)
Boys 12 Years & Under (Born 2005 or after)
Girls 12 Years & Under (Born 2005 or after)
Boys 14 Years & Under (Born 2003 or after)
Girls 14 Years & Under (Born 2003 or after)
Boys 16 Years & Under (Born 2001 or after)
Girls 16 Years & Under (Born 2001 or after)
Boys 18 Years & Under (Born 1999 or after)
Girls 18 Years & Under (Born 1999 or after)
Totals
Upon receipt of nomination an invoice
will be sent with 7 day payment terms.
If a team withdraws from the
tournament at least 7 days prior to the
event a full refund will be given.
Please return this form to:
BMTA - PO BOX 1167, CARINDALE QLD 4152 or [email protected]
Phone 3397 5133
Total