Please note - this is just a submission form for an expression of interest. You will not be required to pay until your team has been approved.

Up to 10 players (8 or 9 recommended).

Club Name

Which Football QLD Football/futsal club are you from?

Name coach/manager

First Name

Last Name

Email

Phone

(###)

###

####

Competing Ages

How many teams and what ages are you interested in entering?

Team Colours

Please add your primary team colours.

Message

Please advise if you would like to add any other comments.