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:-------------------Boys Teams:-------------------U11 PurpleU11 BlueU11 GreyU12 PurpleU12 BlueU12 GreyU12 OrangeU13 PurpleU13 BlueU13 GreyU14 PurpleU14 BlueU14 OrangeU14 GreenU14 JPLU15 PurpleU15 BlueU15 OrangeU16 PurpleU18 BlueU18 GreyOpen Age Mens-------------------Girls/Women's Teams-------------------U12 Purple GirlsU12 Grey GirlsU13 Blue GirlsU14 Purple GirlsU17 Purple GirlsWomen's TeamU11 Teams - Please select competition type:(Required)Please choose:League MatchLeague 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 £12.00U14 JPL Team - Please select competition type:(Required)Please choose:League 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 £12.00U17 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: £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)
