Regional School Futsal Titles

WINTER STATE TITLES

Welcome to the 2025 Winter State Titles Entry Form. Please fill in all fields marked with an *. Incomplete entries may not be processed and or delayed.

Registrations may only be completed in an age group if your school has not qualified for Champion of Champions in that age group.

Which State Titles are you registering for:

Contact Details:

Please input your school and contact details below.

School:*

School Contact Teacher:*

School Postal Address:*

Suburb:*

Postcode:*

State:*

School Phone Number:*

Mobile Phone Number:*

Email Address:*

Additional Email Address to receive all information:

TEAM ENTRY SELECTION:

Please indicate the amount of teams you wish to enter by placing the number in the fields below.

9 Boys*

(Born 2016)

10 Boys*

(Born 2015)

11 Boys*

(Born 2014)

12 Boys*

(Born 2013)

13 Boys*

(Born 2012)

14 Boys*

(Born 2011)

15 Boys*

(Born 2010)

16 Boys*

(Born 2009)

19 Boys*

(Born 2005)

10 Girls*

(Born 2014)

11 Girls*

(Born 2013)

12 Girls*

(Born 2012)

13 Girls*

(Born 2012)

14 Girls*

(Born 2011)

16 Girls*

(Born 2009)

19 Girls*

(Born 2005)

Optional Player Insurance:*

$7.00Per Player

QTY *

Additional Notes:*

Accounts Payable Email Address:*

For invoicing purposes. This email address MUST be different from teacher contact email.

Terms & Conditions:

By submitting this entry into the 2024 Winter State Titles you therefore abide by the Australian Futsal Association Rules and Regulations as stated in the 2024 School Futsal Tournament Regulation Booklet. This booklet can be downloaded at www.schoolfutsal.com. It will also be available at all tournaments and can be sent out via mail upon request.

You understand that draws and all subsequent information is subject to change up until 5pm on the day before your nominated school titles. All schools must be available to play between the set hours for each tournament unless a written email request has been submitted.

You also agree that should you remove any team from a competition after a draw has been released you will be subject to a withdrawal fee of 50% per team withdrawn.

Coaches and Team Officials are prohibited from wearing uniforms that identify them as members of or advertise private futsal clubs, programs or academies that are not affiliated with Australian Futsal Association.

The distribution of marketing materials is not allowed with the written approval of the Australian Futsal Association during all tournaments and events.

I Agree T&C's:*

Yes

Media:

I hereby grant Australian Futsal Association, the Member Federation, the Competition Administrator and the Club (Futsal Administrators) a non-exclusive, royalty free, world-wide, irrevocable license to use your name and/or image in any form or media format for the purpose of marketing and promotional activities.

You agree that all participants have a signed Media Release form and photos or videos taken at our tournaments may be used for Australian Futsal purposes.

I Agree Media:*

YesNo

INVOCIED?

Payment Details

Receipt