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gold coast futsal Registrations

If you would like to register yourself, please complete the Registration Form below,

Registration is a two step process
1. Complete the Player Registration Form
2. Complete the Online Secure Payment Section

Please Note that players aren't Registered until Full payment is made to Gold Coast Futsal

 
Futsalplayer Registration
2009 - 2010 Competition Price
 
Game Fees
Player registration
Open Mens League
$10.00 per week
$85.00
Open Ladies League
$10.00 per week
$85.00
Open Mixed League
$10.00 per week
$85.00
Junior League
$145 Once off payment
$85.00
Futsal player Registration

 

REGISTRATION OF
AMATEUR PLAYER
Prescribed Form NRR03
 
1. Have you registered with FFA Previously ? YES NO
If Yes, please write your FFA Registration Number
 
PARENT DETAILS
(To be completed if player is under the age of 18 years)
PLAYER DETAILS
2. Title
3. First Name
Middle Name
Surname
4. Date Of Birth
5. Age group appiled for
6. Gender Male Female
7. Address
Suburb
State
Post Code
8. Country of Birth
9. Nationality
10. Are you aboriginal or Torres Strait islander? YES NO
11. Player contact phone/email(please provide at least one phone number)
12. Emergency Contact
(name)
(phone)
(mobile)
 
18. Parent/legal guardian
Title
First Name
Middle Name
Surname
Gender Male Female
Contact phone/email(please provide at least one phone number)
SCHOOL DETAILS
19. Are you a student? YES NO
20. If under 18 years of age and at school, please provide namae of school
21. Do you play for the school team? YES NO
SIGNING
The Club and the Player as listed above apply to Football Federation Australia Limited to register the Player with that Club as an AMATEUR PLAYER.
By signing this form, the Player(or if the Player is under 18 years of age at the time of signing this form, that Player's parent or legal guardian) agrees to comply with the Terms and its incorporated documents, including the FFA Statutes and Spectator Code of Behaviour.
(Name of Player or Parent/Legal Guardian) (Date)
 
REGISTRATION DETAILS
13. Name of club
Name of team playing for
14. Registering to Play
15. Previous national association
(If the previous national association was based overeas, FFA must obtain an International Transfer Certificate)
16. Previous Club
17. Are you currently under suspension?
if Yes, how many matches/weeks remaining
Name of football organisation which issued the suspension?
 
 
I understand that I am not Fully Registered until Payment is made to Gold Coast Futsal