Your Name:(Required)Please choose:Jason PickettGiles KempChris BennettDan StephensDarren LoveridgeChris HorganTerry GriffinDuncan SimpsonMike Reilly/Melanie BallSteve JacksonTony RendallAdam StubbsDave HoganSimon CowleyDaniel McGillLeo JonesCraig HardingJanarth PerinpanayagamDaniel HawkinsMark PottonWayne JohnstoneMichael DennisLisa SmithAndyPlease select your team:(Required)Please Choose:U11 Purple MixedU11 Blue MixedU11 Grey MixedU11 Orange MixedU12 Purple MixedU12 Blue MixedU12 Grey MixedU12 Purple GirlsU13 Purple GirlsU13 Blue MixedU13 Grey MixedU13 Grey GirlsU13 Orange MixedU14 Purple MixedU14 Blue MixedU14 Grey MixedU14 Blue GirlsU15 Purple MixedU15 Orange MixedU15 Green MixedU15 Purple GirlsU15 MJPLU16 Purple MixedU16 Blue MixedU18 Purple MixedMens First TeamMens Development TeamLadies First TeamLadies Development TeamLeague Match Fee Paid:(Required) Price: U12 Teams - Please select competition type:(Required)Please choose:League MatchCounty Cup MatchLeague Cup MatchLeague Match Fee Paid:(Required) Price: County Cup Match Fee Paid:(Required) Price: £22.00 total fee - Half Fee Owed £11.00League Cup Match Fee Paid:(Required) Price: £22.00 total fee - Half Fee Owed £11.00U13 Teams - Please select competition type:(Required)Please choose:League MatchCounty Cup MatchLeague Cup MatchLeague Match Fee Paid:(Required) Price: County Cup Match Fee Paid:(Required) Price: £24.00 total fee - Half Fee Owed £12.00League Cup Match Fee Paid:(Required) Price: £24.00 total fee - Half Fee Owed £12.00U14 Teams - Please select competition type:(Required)Please choose:League MatchCounty Cup MatchLeague Cup MatchLeague Match Fee Paid:(Required) Price: County Cup Match Fee Paid:(Required) Price: £24.00 total fee - Half Fee Owed £12.00League Cup Match Fee Paid:(Required) Price: £24.00 total fee - Half Fee Owed £12.00U15 JPL Team - Please select competition type:(Required)Please choose:League MatchCup MatchLeague Match Fee Paid:(Required) Price: U15 Teams - Please select competition type:(Required)Please choose:League MatchCounty Cup MatchLeague Cup MatchLeague Match Fee Paid:(Required) Price: County Cup Match Fee Paid:(Required) Price: £28.00 total fee - Half Fee Owed £14.00League Cup Match Fee Paid:(Required) Price: £28.00 total fee - Half Fee Owed £14.00U16 Teams - Please select competition type:(Required)Please choose:League MatchCounty Cup MatchLeague Cup MatchLeague Match Fee Paid:(Required) Price: County Cup Match Fee Paid:(Required) Price: £28.00 total fee - Half Fee Owed £14.00League Cup Match Fee Paid:(Required) Price: £28.00 total fee - Half Fee Owed £14.00U18 Teams - Please select competition type:(Required)Please choose:League MatchCounty Cup MatchLeague Cup MatchLeague Match Fee Paid:(Required) Price: County Cup Match Fee Paid:(Required) Price: £30.00 total fee - Half Fee Owed £15.00League Cup Match Fee Paid:(Required) Price: £30.00 total fee - Half Fee Owed £15.00Men's Team - Please select competition type:(Required)Please choose:League MatchCounty Cup MatchLeague Cup MatchLeague Match Fee Paid:(Required) Price: Referee Home Postcode:(Required)Miles to Moredon from Referee Postcode: Quantity(Required) Price: £ 0.45 Quantity County Cup Match Fee Paid:(Required) Price: £45.00 total fee - Half Fee Owed £22.50League Cup Match Fee Paid:(Required) Price: £45.00 total fee - Half Fee Owed £22.50Total to pay: U12 Girls Teams - Please select competition type:(Required)Please choose:League MatchCounty Cup MatchLeague Cup MatchLeague Match Fee Paid:(Required) Price: County Cup Match Fee Paid:(Required) Price: £22.00 total fee - Half Fee Owed £11.00League Cup Match Fee Paid:(Required) Price: £22.00 total fee - Half Fee Owed £11.00U13 Girls Teams - Please select competition type:(Required)Please choose:League MatchCounty Cup MatchLeague Cup MatchLeague Match Fee Paid:(Required) Price: County Cup Match Fee Paid:(Required) Price: £24.00 total fee - Half Fee Owed £12.00League Cup Match Fee Paid:(Required) Price: £24.00 total fee - Half Fee Owed £12.00U14 Girls Teams - Please select competition type:(Required)Please choose:League MatchCounty Cup MatchLeague Cup MatchLeague Match Fee Paid:(Required) Price: County Cup Match Fee Paid:(Required) Price: £24.00 total fee - Half Fee Owed £12.00League Cup Match Fee Paid:(Required) Price: £24.00 total fee - Half Fee Owed £12.00League Match Fee Paid:(Required) Price: County Cup Match Fee Paid:(Required) Price: £45.00 total fee - Half Fee Owed £22.50League Cup Match Fee Paid:(Required) Price: £45.00 total fee - Half Fee Owed £22.50Women's Team - Please select competition type:(Required)Please choose:League MatchCounty Cup MatchLeague Cup MatchLeague Match Fee Paid:(Required) Price: County Cup Match Fee Paid:(Required) Price: £45.00 total fee - Half Fee Owed £22.50League Cup Match Fee Paid:(Required) Price: £45.00 total fee - Half Fee Owed £22.50Opposition Team:Opposition Club & Team Name:(Required)Date of Match:(Required)DayDay12345678910111213141516171819202122232425262728293031MonthMonth123456789101112YearYear202720262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Referee DetailsPreferred Payment Method:Please choose:CashBank TransferAccount Name (exact):(Required)Please allow up to 5 working days for payment to be sent to youAccount Number:(Required)Sort Code:(Required)Referee Name:(Required)Referee Email Address:(Required) ConfirmationCoach/Manager/Referee - by signing below, you agree that the fee as indicated above has been paid in full (unless bank transfer has been selected). A copy of this form will be sent to the coach/manager, referee and the FC Abbey Meads Treasurer.Referee Signature:(Required)Coach Signature:(Required)
