City Touch - Nominations

Team Management Details
Name:
Date of Birth :
Email Address:	**Mandatory
Address:
Suburb:
Postcode:
Home Phone:
Work Phone:
Mobile:
Fax:

Second Contact Details
Name:
Date of Birth:
Email Address:	**Mandatory
Address:
Suburb:
Postcode:
Home Phone:
Work Phone:
Mobile:
Fax:

Declaration:

My team agrees to abide by the game rules and competition regulations of CITY TOUCH. By signing this agreement I am entering into a binding agreement for the entire length of the season. I agree to be solely responsible for all nominations and related fees payable for the season for the club/team.

Location and Night Preferences

Please indicate if the ground or night preferences are of more importance to your team.
	Night		Ground
Grade Selection
	Mens Mixed Womens
Night Selection Please select two preferences
Monday	Preference	Wednesday	Preference
Tuesday	Preference
Venue Selection Please select three venues
Ashgrove		Preference
Chelmer		Preference
Lutwyche		Preference
Colmslie		Preference
Mt Gravatt		Preference
Newmarket/McCook Park		Preference
Zillmere		Preference
Grange		Preference
Stafford		Preference
Has the team played Touch before? Yes No
Any Team wishing to pay by cash or credit card, please contact the office on 3275 2077. Referee Please nominate an individual in the team who has in interest in becoming a referee. We will contact this individual directly to supply them with further information. Name: Phone: Email: WELCOME ABOARD TO THE WINTER 2010 SEASON OF TOUCH