Brendale Futsal Club - Player Registrations 2022/23
@ South Pine Sports Complex - 620 Pine Rd Brendale - Contact Lisa 0408 872 973 Email lisadavy@australianfutsal.com
Player name
*
First Name
Last Name
Parent/Guardian (if player under 18 Years)
First Name
Last Name
Phone Number
*
-
Area Code
Phone Number
Email
*
example@example.com
Player Date of Birth
*
-
Day
-
Month
Year
Date
School Attending (if under 18)
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Are you a member of a team already (choose one below)
*
Yes
No Please place me in team
Team name / Coach name
*
Would you like information about becoming a Referee?
Yes - Please contact me
No
COMPETITIONS 2022 -
*
JUNIORS - Inc Futsal School and ages 6 to 17s
SENIORS
SENIOR FUTSAL
*
Brendale Social Men MONDAY Starts 5th September
Brendale A Grade Men THURSDAY Starts 8th September
Brendale B Grade THURSDAY Starts 8th September
Brendale Social Men THURSDAY Starts 8th September
My Products
*
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Brendale Futsal School - Friday
Futsal School is a combination of training and games. Ages 5 to 10yrs.
$
160.00
AUD
Brendale Under 6 /7s THURSDAY-Term 4
Starts 5th September
$
160.00
AUD
Brendale Under 8/9s FRIDAY
Starts 5th September
$
290.00
AUD
Brendale Under 10/11s FRIDAY
Starts 5th September
$
290.00
AUD
Brendale Under 12/13s FRIDAY
Starts 5th September
$
290.00
AUD
Brendale Under 14/15s MONDAY
Starts 5th September
$
290.00
AUD
Brendale Under 16/17s MONDAY
Starts 5th September
$
290.00
AUD
Futsal Balls (Brendale)
Futsal Ball size 3 and 4 available** Price includes Postage (Aust). Goods posted to Address above.
$
44.00
AUD
Size
Quantity
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Size 4 Ball
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Pay with Credit Card
Debit or Credit Card
First Name
Last Name
Credit Card Number
Security Code
Card Expiration
Please click one of the PayPal options to complete payment and
submit
the form.
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