Mackay Futsal Club - Player Registrations 2022/23
Contact Leo 0447 638 976 cqdoc@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? - Paid position
Yes - Please contact me
No
My Products
*
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Mackay Gol Brasil Academy Term 4 (with uniform incl)
Term 4 Academy / Includes uniform
$
180.00
AUD
Mackay Gol Brasil Academy Term 4 (without Uniform)
Term 4 Academy / does not include uniform.
$
140.00
AUD
Mackay Under 7/8s
16 week season- including finals
$
200.00
AUD
Mackay Under 9/10s
16 week season- including finals
$
200.00
AUD
Mackay Under 11s
16 week season- including finals
$
200.00
AUD
Mackay Under 12s
16 week season- including finals
$
200.00
AUD
Mackay Under 13s
16 week season- including finals
$
200.00
AUD
Mackay Under 14s
16 week season- including finals
$
200.00
AUD
Mackay Under 15s
16 week season- including finals
$
200.00
AUD
Mackay Under 16s
16 week season- including finals
$
200.00
AUD
Mackay Senior Mens
$
180.00
AUD
Mackay Social Mixed
$
180.00
AUD
Futsal Balls (Mackay)
Futsal Ball size 3 and 4 available** Price includes Postage (Aust). Goods posted to Address above.
$
44.00
AUD
Size
Quantity
Size 3 Ball
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
100
Size 4 Ball
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
100
Payment Methods
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.
Submit
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