EmailMe Form - Five a Side Team Nomination Form

Team Name (subject to availability) *

Managers Details (This person will receive all team correspondence)

First Last

Email *

email@email.com

Phone *

### - ### - ####

Please select your teams preference:

Preferred Playing Night?

TEAM PLAYER DETAILS:

	First Name	Surname	DOB	Email	Phone number
Player 1
Player 2
Player 3
Player 4
Player 5
Player 6
Player 7
Player 8
Player 9
Player 10

5 A Side Player registration is $660 per team and must be PAID IN FULL AS A TEAM, prior to season start. There will be no other match fees charged per game. * Please choose one: *

Direct Bank Transfer ANZ, Account Name - Wollongong Wolves FC, BSB: 012 827 ACCOUNT NO : 3984 86636 REF : TEAM NAME

Credit card via phone 0412 083 754 or below

Send cheque to 32 Waverley Drive, Unanderra NSW 2526

An invoice will be emailed to your Team Manager once your competition details are confirmed. Payment must be made in full in order to secure your team's position in the competition.