THREE COUNTIES ABILITY COUNTS FOOTBALL
LEAGUE REGISTRATION FORM
2013/14
Thank you for your interest in the FA Three Counties Ability Counts Football League. In order to
be part of this league, we require you to complete the following form, along with payment and
submit to the League Secretary, Stefan Watts before the closing date:
Friday 9th September 2016.
LEAGUE REGISTRATION FORM SEASON 2016/2017
Club / Team…………………………………………………….………………………………………………………………….FC
Secretary Details:
Name: …………………………………………………………………………………………………………..
Address:(inc Postcode)………………………………………………………………………….........
……………………………………………………………………………………………………………………..
…………………………………………………………………………………………………………………….
DOB……………………………………………………………………………………………………………..
Telephone Number (H)…………………………………………………………………………………
Telephone Number (M)…………………………………………………………………………………
Email Address:………………………………………………………………………………………………
Welfare Officer Details:
Name: …………………………………………………………………………………………………………..
Address:(inc Postcode)………………………………………………………………………….........
……………………………………………………………………………………………………………………..
……………………………………………………………………………………………………………………..
Telephone Number (H)…………………………………………………………………………………
Telephone Number (M)…………………………………………………………………………………
Email Address:………………………………………………………………………………………………
Home Colours: (Shirts/Shorts/Socks)…………………………………………………………...
…………………………………………………………..
Away Colours: (Shirts/Shorts/Socks)……………………………………………………………
………………………………………………………….
Emergency Contact Name and Telephone Number: (must NOT be the Secretary)
………………………………………………………………………………………………………………….
County Affiliation Details (County and Number):
…………………………………………………………………………………………………………………
Can these details be used on the League Website?.........................................................
(Name and phone number only may be used to facilitate team contacts)
Do you wish to enter more than one team? (Delete as appropriate) Yes / No
ADULT PLAYER REGISTRATION FORM:
Club Manager: ……………………………………………………………………………………….
Team Coach: ………………………………………………………………………………………….
Players Name
1
2
3
4
5
6
7
8
9
10
11
12
13
D.O.B
Emergency Contact
name and number
Email address
14
ADDITIONAL TEAMS
Team Name:
……………………………………………………………………………………………………………………………………… FC
Home Colours: (Shirts/Shorts/Socks)…………………………………………………………...
…………………………………………………………..
Away Colours: (Shirts/Shorts/Socks)……………………………………………………………
………………………………………………………….
ADULT PLAYER REGISTRATION FORM:
Club Manager: ……………………………………………………………………………………….
Team Coach: ………………………………………………………………………………………….
Players Name
1
2
3
4
5
6
7
D.O.B
Emergency Contact
name and number
Email address
8
9
10
11
12
13
14
IN FUTURE THE LEAGUE MAY NEED TO MAKE A CHARGE TO REGISTER INDIVIDUAL PLAYERS TO PROVIDE
SUFFICIENT FUNDS TO OPERATE THE LEAGUE TOURNAMENTS. THIS YEAR AND ONWARDS ALL TEAM
PLAYERS MUST BE REGISTERED PRIOR TO THE SEASON START AND TEAMS WILL NOT NORMALLY BE
PERMITTED TO ENTER ANY SUBSTITUTES UNLESS THE LEAGUE COMMITTEE HAS PROVIDED WRITTEN
AUTHORITY. THIS AUTHOURITY WILL NOT BE WITHHELD UNREASONABLY TO TAKE ACCOUNT OF THE
SPECIAL CIRCUMSTANCES THAT SOME PLAYERS MAY EXPERIENCE.
Payment:
Entry into the League is £60 per team. Teams can pay by cash or cheque . Please include your payment
along with registration form(s).
Forms to be sent to:
Stefan Watts, (League Secretary)
Shropshire Football Association
Oteley Road
Shrewsbury
SY2 6ST
[email protected]