. Southern Lions Rugby Union Football Club. @SLRUFC. Team Nomination Form. Team Na
Team Nomination Form Team Name: _____________________________________________________________________ Team Colours: ___________________________________________________________________ Team Contact: ________________________________ Contact No: ________________________ Tournament Category: U8 or U10 or U12 or Boys U14 ‐ U16 ‐ U18 or Girls U15 ‐ U18 (please circle) No. 1 2 3 4 5 6 7 8 9 10 11 12 13
Jumper
Given Name
Surname
MRID #
14
15
Coach Asst Coach Team Manager Physio
Coaching Qualifications
Note – ALL players must be registered in the ARU RugbyLink System for insurance reasons. Unregistered players are not covered by ARU Insurance. We understand and acknowledge by the receipt of this form that our team will abide by the Tournament Rules and Conditions of Entry which includes payment of a $200 (inclusive of GST) participation fee to accompany this nomination form.
Name _____________________ Signature_______________________ Date__________ Please complete and return to
[email protected] by 12pm Friday 20th October 2017. Payment must be received by 12pm Friday 27th October 2017.
Account details for Electronic Fund Transfer / Bank Deposit are: BankWest, Account Name – Leeming RUFC, BSB – 306110, Account Number – 4174680 Please confirm your payment by sending a remittance advice to
[email protected]
Email:
[email protected]
Southern Lions Rugby Union Football Club
@SLRUFC
