Kilmarnock

Kilmarnock Supporters

5-a-Side Football Challenge.

To be held at Powerleague Fives

Sunday 22nd January.  2pm Kick Off

 

Application Form

 

Contact details

 

Organisers Name

 

Team Name

 

 

Company or Organisation

 

 

Address

 

 

 

 

 

Postcode

 

 

Telephone Numbers

 

Work:                    

 

Work Fax:

 

 

Mobile:

 

Evening:

 

Programme

From 1.30pm              Teams arrive and player registration

1.45pm                        Welcome Packs, Captains Meeting

2.00pm                        First games kick off

5.00pm                        Grand Final

5.30pm                        Presentation of prizes to Winners & Runners Up

                                    by Kilmarnock FC representative

 

Entry Fee and Payment

Only £40 for each team of which 50% goes to Kilmarnock FC Youth Development.  This fee includes all refereed football, winners & runners up prizes and bar promos.  Please complete the details below to reserve your place in the tournament & return to Peter Alexander, Kilmarnock Supporters Tournament, Powerleague Kilmarnock, Queens Drive, Kilmarnock, KA1 3XF

Please make cheques payable to “Powerleague Fives Ltd”

Credit Card No:                                               Type:                           Expiry:

 

Start:                           Sec code:                    (last 3 digits on reverse of card)
 
 

 

 

 


Complete, sign and fax or post this form back to us to register.

Fax (Powerleague) 01563 55 70 71 –we will call to confirm receipt

 

For more info e-mail Kilmarnock@powerleague.co.uk or call 01563 55 70 70 Text Box: Powerleague Kilmarnock Former Kirkstyle Cricket Ground, Queens Drive, Kilmarnock, KA1 3XF. (t) 01563 55 70 70 (e) Kilmarnock@powerleague.co.uk

Please note – players cannot wear blades. 

On occasions Powerleague may be running special promotions, events and other activities we would like you to hear about. If you don’t want us to get in touch, tick here.m

 

Team Organiser signature:                                                              Date:                     

 

Below for Powerleague use only (circle relevant)

Entry form received by:                          Date

Payment received by:                             Date        

Paid By: (circle relevant)                                   

Cash                                        Chq                          Card