BRISBANE METROPOLITAN TOUCH ASSOCIATION
ADULT INDIVIDUAL NOMINATION FORM
First Name:
Surname:
Address:
Suburb:
P/code:
Daytime Contact:
Evening Contact:
Mobile:
Email:
TO ASSIST US IN PLACING YOU IN A TEAM PLEASE COMPLETE THE FOLLOWING:
Preferred Competition Location:

Whites Hill
Preferred Competition Type:



Beginner (never played before)
Played before
Elite (have played representative football before)
If you have played before, please provide details: ________________________________________________
Type of team you would like to join:  Mens
(Whites Hill – Mon, Tue, Wed. O’Grady Park – Mon, Wed)
(You can select more than one competition type)  Womens
(Whites Hill – Wed)
 Mixed
(Whites Hill – Mon, Tue, Wed. O’Grady Park – Mon, Wed)
 Mens over 30’s (Whites Hill –Wed)
 Mens over 40’s (Whites Hill –Wed)
 Metro Cup (Mixed A Grade) (Whites Hill – Mon)
Your age group:
Under 18
How fit would you say you were?
18-25



26-35
36-45
Over 46
Very Fit
Average Fitness
Making this my fitness for the week
Are you prepared to organise a team if supplied with the names and contact details of other similarly interested
people?
 Yes
 No
Any other comments that may assist us in placing you in a team: ____________________________________
________________________________________________________________________________________
On receipt of this form, we will enter your details onto a database of individuals looking to join teams. Your
contact details only will then be forwarded on to teams looking for players. Team contacts will contact you
directly. While every effort is made to assist you with this application, we cannot guarantee that you will be
placed into a team.
PLEASE RETURN TO BMTA
PO BOX 1167 CARINDALE QLD 4152
PH: 3397 5133 Email: [email protected]