DORSET DISABILITY CUP COMPETITION 2015 This summer Dorset FA are hosting Dorset Disability Cup at Blandford, with competing teams able to win the first Disability Cup. The competition will host a male 7-aside competition on Sunday 14th June, and a disability football coaching festival for female footballers. There are limited numbers of spaces available and these will be issues on a ‘first come first served basis’. TEAM DETAILS Team Name Main Contact Email Phone Address Ability Banding- League Tier (please tick as appropriate) Championship League Teams will compete in either Championship (higher ability) or league (lower ability). Teams will compete in a group of six teams, playing a total of five games. Group winners will play the runners up in the other pool in the semi-finals , and the winners of these matches will play each other in the final. Please return your completed application form, along with entry fee of £25.00 (cheques payable to ‘DCFA Ltd’ no later than 27th April 2015 (9AM) to: Rosie Eggleston, Dorset County FA, Blandford Close, Hamworthy, Poole, BH15 4BF Alternatively you can email your entry form to: [email protected] and pay via card over the phone please call: 01202 688273. www.DorsetFA.com @DorsetCFA 01202 688273 Player Registration All information collected by the Dorset Disability Cup to effectively administer matters relating to the competition will be used in accordance with the Data Protection Act (1988). All Parents, players, and guardians are taken to have consented to this by signing this registration form. We are aware that Dorset County FA their staff, or any facility is under no liability in respect of injury which may be sustained during this activity. We are also aware that photographs may be taken by authorised DCFA staff, and may be used for marketing or promotional purposes. Players Name D.O.B Address Disability Photographic Consent 1. Choose an item Choose an item. 2. Choose an item. Choose an item. 3. Choose an item. Choose an item. 4. Choose an item. Choose an item. 5. Choose an item. Choose an item. 6. Choose an item. Choose an item. 7. Choose an item. Choose an item. www.DorsetFA.com @DorsetCFA 01202 688273 Player Registration Players Name D.O.B Address Disability Photographic Consent 8. Choose an item Choose an item. 9. Choose an item. Choose an item. 10. Choose an item. Choose an item. www.DorsetFA.com @DorsetCFA 01202 688273
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