Wexford & District Schoolboys League Affiliated to the SFAI and FAI Application for Membership Season 2019/2020 BLOCK CAPITALS (Please fill in all the form) COPY OF CLUBS PUBLIC LIABILITY INSURANCE MUST ACCOMPANY THIS FORM Club: ............................................................................ Location of Ground: ............................................................................................. No. of Teams: 9s ................ 10s................ 11s…….....… 12s.…….....… 13s.….....…… 14s.…….....…. 15s….....…… 16s….....…… Colours: 9s .............................................................................................................../................................................................................... Colours: 10s ............................................................................................................./................................................................................... Colours: 11s ............................................................................................................./................................................................................... Colours: 12s ............................................................................................................./................................................................................... Colours: 13s ............................................................................................................./................................................................................... Colours: 14s ............................................................................................................./................................................................................... Colours: 15s ............................................................................................................./................................................................................... Colours: 16s ............................................................................................................./................................................................................... Please fill in Names, Address & mobile phone numbers BLOCK CAPITALS Chairman: ........................................................................................................................Tel: Vice Chairman: ................................................................................................................Tel: Secretary (Schoolboys): ................................................................................................................................................................................ Contact Email: .......................................................................................................Tel: Treasurer: ........................................................................................................................Tel: (COMPULSORY) Registrar: ............................................................................................Tel: Please fill in ALL Team Managers Names & Phone numbers BLOCK CAPITALS 9s ................................................................................................................................................................................................................... 10s ................................................................................................................................................................................................................. 11s ................................................................................................................................................................................................................. 12s ................................................................................................................................................................................................................. 13s ................................................................................................................................................................................................................. 14s ................................................................................................................................................................................................................. 15s ................................................................................................................................................................................................................. 16s ................................................................................................................................................................................................................. IMPORTANT: Please tick box to grant permission to use information on WDSL website. Please fill in Name, Address & Phone number of Child Protection Officer BLOCK CAPITALS .................................................................................................................................................................................................................................................................................... .........................................................................................................................................Tel: The Club Secretary must complete (IN BLOCK CAPITALS) and return to the League Secretary by 20th September, 2019 Total €……………………(Affiliation Fee) Signed………………………………………………Club Secretary AFFILIATION FEES: Per Club: 1-5 teams €350 • 6-10 teams €400 • Over 10 teams €450 + €5 per child registered AFFILIATION FEES TO bE SENT TO ThE LEAGUE TREASURER (M. CARThY , 40 KING ST ., WEXFORD), bEFORE START OF SEASON
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Wexford & District Schoolboys LeagueAffiliated to the SFAI and FAI
Application for Membership Season 2019/2020BLOCK CAPITALS (Please fill in all the form)
COPY OF CLUBS PUBLIC LIABILITY INSURANCE MUST ACCOMPANY THIS FORM
Club: ............................................................................ Location of Ground: .............................................................................................
No. of Teams: 9s ................ 10s................ 11s…….....… 12s.…….....… 13s.….....…… 14s.…….....…. 15s….....…… 16s….....……
Colours: 9s .............................................................................................................../...................................................................................
Colours: 10s ............................................................................................................./...................................................................................
Colours: 11s ............................................................................................................./...................................................................................
Colours: 12s ............................................................................................................./...................................................................................
Colours: 13s ............................................................................................................./...................................................................................
Colours: 14s ............................................................................................................./...................................................................................
Colours: 15s ............................................................................................................./...................................................................................
Colours: 16s ............................................................................................................./...................................................................................Please fill in Names, Address & mobile phone numbers
BLOCK CAPITALSChairman: ........................................................................................................................Tel:
Vice Chairman: ................................................................................................................Tel:
Secretary (Schoolboys): ................................................................................................................................................................................
Contact Email: .......................................................................................................Tel:
Treasurer: ........................................................................................................................Tel:
(COMPULSORY) Registrar: ............................................................................................Tel:
Please fill in ALL Team Managers Names & Phone numbersBLOCK CAPITALS
9s...................................................................................................................................................................................................................
10s.................................................................................................................................................................................................................
11s .................................................................................................................................................................................................................
12s.................................................................................................................................................................................................................
13s.................................................................................................................................................................................................................
14s.................................................................................................................................................................................................................
15s.................................................................................................................................................................................................................
16s.................................................................................................................................................................................................................IMPORTANT: Please tick box to grant permission to use information on WDSL website.
Please fill in Name, Address & Phone number of Child Protection OfficerBLOCK CAPITALS....................................................................................................................................................................................................................................................................................
.........................................................................................................................................Tel: The Club Secretary must complete (IN BLOCK CAPITALS) and return to the League Secretary by 20th September, 2019
Total €……………………(Affiliation Fee) Signed………………………………………………Club Secretary
AFFILIATION FEES: Per Club: 1-5 teams €350 • 6-10 teams €400 • Over 10 teams €450 + €5 per child registeredAFFILIATION FEES TO bE SENT TO ThE LEAGuE TREASuRER (M. CARThy, 40 KING ST., WExFORD), bEFORE START OF SEASON
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