FUTSAL STATE REPRESENTATIVE TEAM | TRIAL REGISTRATION FORM

1

This form is for players and teams wishing to register for the Northern Inland Futsal Festival 2025 at Tamworth Sports Dome

All teams/players must register, but participation is FREE.

If you have any queries, please contact Damon Shaw at dshaw@northernnswfootball.com.au

2

What are you registering for?* This field is required.

Open men's tournament

Open women's tournament

9am- 11am Training session (6-11 years old, boys and girls)

11am- 1pm Training session (12-16 years old, boys and girls)

Open men's tournament - individual player or referee

Open women's tournament - individual player or referee

3

Team name

4

Team manager

First Name

Last Name

5

Email

example@example.com

6

Are you interested in playing a state wide competition as part of the NNSWF futsal pathway?

YESNO

7

Would you be interested in a foundation of futsal course in 2025?

YESNO

8

Name* This field is required.Name of player

First Name

Last Name

9

Gender

Male

Female

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Date of birth* This field is required.

Date

11

Football Club and LeagueWhich football club and league do you play in?

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Are you interested in further futsal training as part of the Talent Development Pathway?

YESNO

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Name

First Name

Last Name

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Contact phone number* This field is required.

15

Contact email* This field is required.

16

Any medical issues