Football Five5 Summer Leagues 2023 Registration Seniors

Football Five5 Summer Leagues 2023 Registration Seniors

Team Nomination Form
Football SA is proud to host Football Australia’s (FA) official ‘5-a-side’ brand Football Five5, here at the new State Centre for Football.

Starts: Monday 30 Jan/Wednesday 1 Feb - Ends: Monday 3/Wednesday 5 April

10 Week Competition

Registrations close: Thursday 26 January

Times: Pick your night! Monday Or Wednesday Night 6:40pm onwards

Leagues: Men, Women & Mixed 17+ Minimum Age

Location: State Centre For Football

Cost: $50 Registration Per Team

$85 Match Fee Per Team

To nominate your team for the Football Five5 Summer Leagues please complete this form.
Name of Contact Person*

First NameLast Name
Date of Birth*

DayMonthYear
Date
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Competition*
Preferred Night*
General Team Ability *
Team Name*
Name - Player 1

First NameLast Name
Name - Player 2

First NameLast Name
Name - Player 3

First NameLast Name
Name - Player 4

First NameLast Name
Name - Player 5

First NameLast Name
Name - Player 6

First NameLast Name
Name - Player 7

First NameLast Name
Name - Player 8

First NameLast Name
Name - Player 9

First NameLast Name
Name - Player 10

First NameLast Name

My Products*

Football Five5 Summer Leagues Registration

$50.00AUD

Total

$0.00AUD

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

Declaration

The information outlined in this nomination form is true and correct. All player and team officials will be required to abide by the Rules and Regulations of Football Australia and Football SA during their involvement in the Football Five5 Competition.

All players and team officials must be registered with the Football SA in accordance to the process provided and agree to pay all fees associated with players participating in the competition.
Did you play in the Football Five5 Summer Leagues 2022?*
How did you hear about Football Five5?

Social mediaRadioSMSThrough a friendFootball clubOther
Name*

First NameLast Name
Signature*

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