5-a-side Team Nomination Form
Summer 2016
Senior Competition:
Junior Competition:
Please complete and return by to:
Scott Collis, General Manager, Southern Cross Football Centre (Ph 0438 459 813)
Email: [email protected] or PO Box 157, Lismore NSW 2480
Team Name
Team Contact Name
Email
Mobile
Senior men

Senior Women

Over 35’s Men

Over 35’s Women

Mixed

Junior boys

Junior girls

Division *
Junior Age group ………………… years
* Competition divisions will only proceed subject to sufficient nominations for that division being
received.
Seniors commence Wednesday 24th February then every Wednesday for 7 weeks
Juniors commence Tuesday 23rd February then every Tuesday for 7 weeks
There will be 7 rounds
Registration costs are $400 for Senior teams and $300 for Junior teams (based on 8 players per
team @ $50 per player for seniors and $37.50 per player for juniors).
To enter, complete and return this team nomination form. An email will be sent to you confirming
your team nomination and providing a team registration pack including direct deposit banking
details for payment of registration fees.
Team registrations will only be considered complete once registration fees are paid in full.
Registrations must be completed before 17th February 2016 for seniors and juniors.
Updated: 4 May 2015