Mombasa Interchurches Sports Evangelism Registration Form 2025

Name of the Church Name

Type Church Name

Sub County

FootballBasketballVolleyballOther

Youth FootballMen FootballLadies Football

Name of the Youth Football Team

Youth Football Team Color

Upload your Youth Football Team Logo

Upload your church or team logo here

Youth Football Team Manager

First NameLast Name

Youth Football Team Managers' Email Address

example@example.com

Youth Football Team Managers' Phone Number

Type Phone Number

Youth Football Team Captain

First NameLast Name

Youth Football Team Captains' Phone Number

Type Phone Number

Please tick where appropriate.

Do you have a good football pitch near or around your church location that you can use for this activity?

Please give the name of the football pitch.

Type the name of the pitch

Name of the Men's Football Team

Men's Football Team Color

Upload your Men's Football Team Logo

Upload your church or team logo here

Men's Football Team Manager

First NameLast Name

Men's Football Team Managers' Email Address

example@example.com

Men's Football Team Managers' Phone Number

Type Phone Number

Men's Football Team Captain

First NameLast Name

Men's Football Team Captains' Phone Number

Type Phone Number

Please tick where appropriate.

Do you have a good football pitch near or around your church location that you can use for this activity?

Please give the name of the football pitch.

Type the name of the pitch

Name of the Ladies Football Team

Ladies Football Team Color

Upload your Ladies Football Team Logo

Upload your church or team logo here

Ladies Football Team Manager

First NameLast Name

Ladies Football Team Managers' Email Address

example@example.com

Ladies Football Team Managers' Phone Number

Type Phone Number

Ladies Football Team Captain

First NameLast Name

Ladies Football Team Captains' Phone Number

Type Phone Number

Please tick where appropriate.

Do you have a good football pitch near or around your church location that you can use for this activity?

Please give the name of the football pitch.

Type the name of the pitch

Men BasketballWomen Basketball

Name of the Men's Basketball Team

Men's Basketball Team Color

Upload your Men's basketball team logo

Upload your church or team logo here

Men's Basketball Team Manager

First NameLast Name

Men's Basketball Team Managers' Email Address

example@example.com

Men's Basketball Team Managers' Phone Number

Type Phone Number

Men's Basketball Team Captain

First NameLast Name

Men's Basketball Team Captains' Phone Number

Type Phone Number

Please tick where appropriate.

Do you have a good basketball court near or around your church location that you can use for this activity?

Please give the name of the basketball court.

Type the name of the pitch

Name of the Women's Basketball Team

Women's Basketball Team Color

Upload your Women's Basketball Team Logo

Upload your church or team logo here

Women's Basketball Team Manager

First NameLast Name

Women's Basketball Team Managers' Email Address

example@example.com

Women's Basketball Team Managers' Phone Number

Type Phone Number

Women's Basketball Team Captain

First NameLast Name

Women's Basketball Team Captains' Phone Number

Type Phone Number

Please tick where appropriate.

Do you have a good basketball court near or around your church location that you can use for this activity?

Please give the name of the basketball court.

Type the name of the pitch

Men VolleyballWomen VolleyballOther

Name of the Men's Volleyball Team

Men's Volleyball Team Color

Upload your Men's Volleyball team logo

Upload your church or team logo here

Men's Volleyball Team Manager

First NameLast Name

Men's Volleyball Team Managers' Email Address

example@example.com

Men's Volleyball Team Managers' Phone Number

Type Phone Number

Men's Volleyball Team Captain

First NameLast Name

Men's Volleyball Team Captains' Phone Number

Type Phone Number

Please tick where appropriate.

Do you have a good volleyball court near or around your church location that you can use for this activity?

Please give the name of the volleyball court.

Type the name of the pitch

Name of the Women's Volleyball Team

Women's Volleyball Team Color

Upload your Women's Volleyball Team Logo

Upload your church or team logo here

Women's Volleyball Team Manager

First NameLast Name

Women's Volleyball Team Managers' Email Address

example@example.com

Women's Volleyball Team Managers' Phone Number

Type Phone Number

Women's Volleyball Team Captain

First NameLast Name

Women's Volleyball Team Captains' Phone Number

Type Phone Number

Please tick where appropriate.

Do you have a good volleyball court near or around your church location that you can use for this activity?

Please give the name of the volleyball court.

Type the name of the pitch

I am fully aware that this sport activity may cause accidental injury to athletes. I hereby declare that I waive my right to pursue any and all claims against the Commission and the Organizing Committee of this event should in any case that the accident, injury, illness or death occurs in the course of any activity held by them.

By signing this form, you affirm that all the information herein is true and correct to the best of your knowledge. Any false information or misrepresentation that shall be found may cause the disqualification of such individual and penalty may be incurred against the team.

Name of Signatory

First NameLast Name

Date Signed

Date