Coordinator Contact Details Club/Team/Grassroots Site Name Coordinator Name Coordinator Phone Ph M Coordinator Email TEAM NOMINATIONS summary Division (Ages are as of 31 December in the year Team Fee Number of Total Due of competition) (GST Inc) Teams Suncorp NetSetGO (girls and boys) $200.00 $ 12 & Under Division (girls & boys) $210.00 $ 14 & Division $210.00 $ 16 & Under Division $210.00 $ 18 & Under Division $210.00 $ Open A Division $240.00 $ Open B Division $240.00 $ Open C Division $240.00 $ Open D Division $240.00 $ Masters Division (35+ years old) $240.00 $ TOTAL ENTRY FEES ALL TEAMS $ TOTAL EARLYBIRD SPECIAL DISCOUNT -$ Deduct $10/team if nominations submitted by Tuesday 26 June 2018 TOTAL AMOUNT DUE $ Carnival rules state a minimum of five Aboriginal or Torres Strait Islander players must that be on court at one time. TEAM PAYMENT DETAILS VISA MASTERCARD CHEQUE box to indicate payment method) Name on Card Card No Card Expiry / CCV Signature Date Receipt Required (receipts will be sent via to the Coordinator) Y N Note teams are only officially registered once payment has been received – PLAYER & OFFICIALS REGISTRATION FORM (1 FORM per team)
Coordinator Contact Details Club/Team/Grassroots Site Name Coordinator Name Coordinator Phone Ph M Coordinator Email TEAM NOMINATIONS summary Division (Ages are as of 31 December in the year of competition) Team Fee (GST Inc) Number of Teams Total Due Suncorp NetSetGO (girls and boys) $200.00 $ 12 & Under Division (girls & boys) $210.00 $ 14 & Division $210.00 $ 16 & Under Division $210.00 $ 18 & Under Division $210.00 $ Open A Division $240.00 $ Open B Division $240.00 $ Open C Division $240.00 $ Open D Division $240.00 $ Masters Division (35+ years old) $240.00 $ TOTAL ENTRY FEES ALL TEAMS $ TOTAL EARLYBIRD SPECIAL DISCOUNT Deduct $10/team if nominations submitted by Tuesday 26 June 2018 -$ TOTAL AMOUNT DUE $ Carnival rules state that a minimum of five Aboriginal or Torres Strait Islander players must be on court at one time. TEAM PAYMENT DETAILS VISA MASTERCARD CHEQUE box to indicate payment method) Name on Card Card No Card Expiry / CCV Signature Date Receipt Required (receipts will be sent via to the Coordinator) Y N Note – teams are only officially registered once payment has been received PLAYER & OFFICIALS REGISTRATION FORM (1 FORM per team)
2018-NAIDOC-Team-Nomination-Form-REVISED-19062018.docx