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Friday Night Bubble Football Competition
Team Name: ____________________________________
Captain’s Details (Primary Contact):
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Name:
_______________________________________________________________
Address:
_______________________________________________________________
Phone:
H: _________________
Email:
________________________________________ (primary contact method)
Team Members:
W: _________________ M: __________________
Contact Number:
Email:
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How did you hear about mpowerdome Indoor Sports?
Played Before 
TV Ad
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Website
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Referral
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Radio Ad
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Newspaper
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Sports Club
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Word of Mouth 
Other  _______________
56 Coyne Street, Fadden, ACT 2904 | P: 6298 5500 | F: 6298 5596 | www.mpowerdome.com.au
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Essential Information & Code of Conduct:
The competition fee of $250 MUST be paid prior to the first game of the competition.
Rules are available at mpowerdome reception or on the mpowerdome website.
Teams are expected to play under the general principles of fair play and good
sportsmanship. Failure to do so may result in penalties to a player and/or team.
The referee’s decisions are final. Players must abide by these decisions.
mpowerdome holds the right to suspend or disqualify a team and/or player from the
competition if their behaviour is deemed unacceptable by mpowerdome management.
Competitions run for 4 weeks including 1-2 weeks of finals/classification matches.
Fixtures, results and ladders are available on the mpowerdome website.
Teams must be in matching playing shirts by the conclusion of the grading period.
A signed nomination form MUST be signed prior to the first game of the competition.
Each player MUST sign the weekly match sheet prior to playing each week. (Penalties
may apply for failing to do so).
Players must be a minimum of 16 years of age to participate.
Declaration:
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In signing this form, I/we understand that:
 I/we participate at mpowerdome at my/our own risk;
 I/we take full responsibility for personal injuries that may arise directly or
indirectly from my/our participation and indemnify mpowerdome against any
legal action;
 I/we take full responsibility for personal property.
 I/we take full responsibility for any and all damage to mpowerdome property which
occurs though our actions outside of scheduled game play and agree to pay repair or
replacement costs as determined by mpowerdome.
 I, on behalf of my team, take responsibility for the actions of both the players and
spectators of my team whilst they are on the mpowerdome premises.
 I, on behalf of my team, understand and accept the rules of competition and any
consequences that may be incurred for failure to comply with these rules.
 I, on behalf of my team, give permission for mpowerdome to take and use photos for
the promotion of mpowerdome programs and that it will be uploaded onto the
mpowerdome Facebook page. I understand that the photos will not be used in any
manner other than described above and that their use must cease upon my request.
Captain’s Signature
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_________________________ Date ___________
OFFICE USE ONLY
Paid  #:______________ |
Data based 
Form Signed 
|
Details Complete  |
| Date: ___/____/___ | By:__________