UCD SUPERLEAGUE 2010/2011
APPLICATION / REGISTRATION FORM
Name of Team: ______________________________________________________________________________________________________
Name & Address of Captain: ___________________________________________________________________________________________
_____________________________________________________________________________________________________________________
Captain’s e-mail address: ______________________________________________________________________________________________
Please give details of Dublin address (if different): _________________________________________________________________________
Phone No:
Home:
Mobile:
THIS FORM MUST BE COMPLETED IN FULL
Name
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
Signature - All players must
sign the form
Faculty
2010/2011
Student Card
No.
Phone Number
E mail Address
Date of Birth
13.
14.
15.
16.
17.
18.
19.
20.
*It is important that the above contact details are correct as this information will be used to contact you regards Superleague notices and promotions of
UCD First Team games
Please state the colour of your teams jerseys:
_______________
Please state, in order of preference, the Division your team wishes to enter.
Premier - Saturday - Saturday a.m. kick-off
Division 1 Saturday - Saturday p.m. kick-off
Premier Sunday - Sunday p.m. kick-off
Division 1 Sunday - Sunday a.m. kick-off
_______________
_______________
_______________
_______________
(Please state at least three preferences).
I confirm that the details contained on this form are true and correct and I further confirm that any inaccurate information contained in this form may lead
to the team being fined, suspended or expelled from the League.
-------------------------------------TEAM CAPTAIN
This form together with the subscription of €55.00 per player should be returned to the Sports Office in the Sports Centre or the Soccer Club Stand during
Freshers week no later than 4.00 p.m. on Thursday 23rd September, 2010. Each team must have at least 16 players registered.