Club Entry Form Season 2022/23 Apply using the form below / Application deadline 30/04/2022

CLICK TO DOWNLOAD ENTRY CRITERIA

Fill in the form below to apply:

FOOTBALL CLUB DETAILS

Name of Football Club:

Home Kit colours:

Team Name:

Away Kit Colours:

Name of Main Contact- Football Club:

Email:

Mobile No:

Name of Finance Contact for Invoice:

Email for invoice:

Address for Invoice:

EDUCATION PARTNER

Name of Education Partner:

Is education delivered at the football club?

Name of Head Coach:

Highest Coaching Qualification:

Name of GK Coach:

Qualification:

Name of Physio/Sports therapist:

Qualification:

Name of Head of Safeguarding:

Qualification:

Email:

TEAM ENTRIES MALE PLEASE ENTER "YES" UNDER THE DIVISION YOU WISH TO ENTER *divisions may be subject to change as new teams join to minimise travel

SOUTH PREMIER DIVISION U23:

NORTH PREMIER DIVISION U23:

MIDLANDS PREMIER DIVISION U23:

CUP ENTRIES - MALE

U23 LEAGUE CUP:

NO OF TEAMS:

FEES CLUB ENTRY £300 AFFILIATION £450 PER TEAM LEAGUE CUP £50 PER TEAM

Total No of Male Team Entries to League:

Total No of Male Cup Entries :

Once entries are approved invoices will be sent to the finance contact. Payment is due by 1st July 2022.

FOOTBALL CLUB ADDRESS

Address Line 1:

Address Line 2:

City/Town:

Postcode:

Country:

Telelphone No:

TRAINING DETAILS AND VENUES

TRAINING VENUE:

Grass or AGP:

Address:

Postcode:

Address line 2:

No of Training Sessions a Week:

No of Goalkeeper Training Sessions a week:

MATCHDAY VENUE (MAIN):

Grass or AGP:

Address:

Dimensions:

Address line2:

Postcode:

MATCHDAY VENUE (2nd):

Grass or AGP:

Address:

Dimensions:

Address line2:

Postcode:

TEAM ENTRIES FEMALE PLEASE ENTER "YES" UNDER THE DIVISION YOU WISH TO ENTER *divisions may be subject to change as new teams join to minimise travel

SOUTH PREMIER DIVISION U23 FEMALE:

NORTH PREMIER DIVISION U23 FEMALE:

MIDLANDS PREMIER DIVISION U23 FEMALE:

CUP ENTRIES - FEMALE

LEAGUE CUP:

NO OF TEAMS:

FEES AFFILIATION £450 PER TEAM LEAGUE CUP £50 PER TEAM

Total No of Female Team Entries to League:

Total No of Female Cup Entries :

Once entries are approved invoices will be sent to the finance contact. Payment is due by 1st July 2022.