2021/2022 Football NSW Summer Football – Application & Description The Application Process to seek Football NSW endorsement of Summer Football Competitions comprises Competition Information Terms and Conditions Both of these processes are combined in this document. Prospective Summer Football Competition Administrators are required to submit this document having answered all questions and executed where required. Upon approval, Football NSW will issue a letter of endorsement to the Competition Administrator. Each Applicant is required to complete this application process. This form must be completed by an authorised person of the Applicant. By submitting the form, the Applicant will be deemed to have reviewed, acknowledged and agreed to the terms and conditions set out in the form without reservation or variation. Should you require any assistance in completing this form please contact the following Football NSW employee: Aaron Dibdin Telephone: (02) 8814 4454 Summer Football 2021/22 Player Registration Fees Name of Applicant (i.e Legal Entity Name)*Designation of Applicant*Football AssociationGrassroots ClubNPL NSW Men's ClubNPL 2 NSW Men's ClubNPL 3 NSW Men's ClubState League ClubNPL NSW Women's ClubNPL NSW Women's ClubRegional BranchABN of Applicant*Phone Number*In What Manner is the Application Provided*Football Association as Competition AdministrationFootball Association as Competition Administration on behalf of Grassroots ClubGrassroots Club as Competition AdministrationNPL or State League Club as Competition AdministrationRegional Branch as Competition AdministrationPlease NoteAll Applicants must be a registered entity i.e. a body corporate registered under the Corporations Act 2001 or an incorporated association registered under the Associations Incorporation Act 2009 (NSW).Applicant Postal Address (please provide street address also if using a PO Box)* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Please NotePlease provide a valid street address for Football NSW Summer Football resources to be posted to.Applicant Website*Please upload a high resolution copy of your Club/Association Logo*EPS files are preferred, but PNG & JPEG files are also acceptedContact Person of Applicant* First Last Contact Phone of Applicant*Contact Person Email Address* Grassroots ClubsGrassroots Clubs are required to seek support of the Football Association to conduct Summer Football Competitions. Please complete the following table should the applicant be a Grassroots Football Club:Football Association In Which You Are Geographically Located*Date At Which You Sought Football Association Support* Date Format: MM slash DD slash YYYY Football Association Support Provided By (Insert Contact Name)* First Last Football Association Support Provided In Writing On (Insert Date)* Date Format: MM slash DD slash YYYY Competition InformationAge grades, venue information, referee information and affiliation resource/subsidy requiredPlease indicate the Gender, Age Grades and Format(s) in which your competition will be conducted i.e. 5v5, 6v6, 7v7 Note: All U6 and U7 competitions must be run in a 4v4 format as per MiniRoos guidelinesCompetitionAge Grade & Division and the Format*Please space entries to show if you are entering more than one age groupVenue Name*Venue Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Do You Access To a Canteen?*YesNoDo You Have Access To a Medical Facilities? (Medical Kit, Medical Room, etc?)*YesNoCompetition Period Commences* Date Format: MM slash DD slash YYYY Competition Period Concludes* Date Format: MM slash DD slash YYYY Application Form & Agreement - 2021/22 Summer Football Season* Select All Monday Tuesday Wednesday Thursday Friday Saturday Sunday Please select the body through which you intend to Acquire Referee Services*Albury/Wodonga Soccer Referee's AssociationBankstown Football RefereesBlacktown City Soccer Referees BranchCanterbury And District Soccer referees Association IncorporatedCentral Coast Football Referees BranchCowra Soccer RefereesDubbo Football RefereesESFA Referees BranchEurobodalla Soccer Referees AssociationFar South Coast Football Referees AssociationFootball South CoastGranville District Football Referees AssociationHills Football Inc.Ku-ring-gai & District Football Referees AssociationManly Warringah Football Referees AssociationMudgee District Referees AssociationMacarthur District Football Referees AssociationNepean Referees GroupNorth West Sydney Football Referees AssociationNSW State League Football RefereesOrange & District Football Referees AssociationShoalhaven District Football AssociationSouth West Slopes Soccer Referees AssociationSouthern Districts Soccer Referees IncSt George Football Referees AssociationSutherland Shire Football Referees AssociationCompetition Regulations*Our Competition Regulations are completeWe are in the process of completing the competition regulations and will provide them prior to the competition commencement datePlease provide us model competition regulations to assist in the drafting processPlease upload a copy of the competition regulationsAdditional Competitions & ProgramsFootball NSW Summer Football Champion of Champions & Walking Football.Summer Football Champion of Champions Festival Football NSW conducts a Champion of Champions festival for any season winning teams or participating teams nominated by affiliated Summer Football hosts in Open Men, Women and Mixed age grades and Walking Football. The Summer Champions Festival is held at Valentine Sports Park, Glenwood in December and hosts teams representing their affiliated competitions from all over NSW in a celebration of the fastest growing format of the game. Check out the video of the 2021 Summer Football Champion of Champions at VSP; View the Video Here Are you interested in nominating a Mens Summer Football Champions of Champions team?*YesNoAre you interested in nominating a Womens Summer Football Champions of Champions team?*YesNoAre you interested in nominating a Mixed Summer Football Champions of Champions team?*YesNoAre you interested in nominating a Mixed Walking Football Champions of Champions team?*YesNoWalking Football The Football NSW Walking Football programs are a low impact, team based sustainable format. Matches are played on weeknights with modified formats (5v5/6v6) on smaller pitches with shortened game times; Walking Football is non-contact with the Walking Rule defined as ‘always having one foot on the ground’; Football NSW Walking Football programs are designed to help people maintain an active lifestyle; and Promote participation of the beautiful game in a fun, inclusive and social environment. Football NSW Walking Football View the Video Here If you would like further information about how we can help you set up a Walking Football program, please contact Trevor Huxley As Host Club of a Summer Football competition are you also interested in operating a Walking Football program utilising the provided FNSW Walking Football Regulations and Formats?*YesNoPlease Send More InformationWould you like Football NSW to assist you in setting you up in PlayFootball?*YesNoAcknowledgement Click Here to review the Endorsement Agreement I,* First Last In my capacity as (insert title)*of (Applicant Association/Branch/Club)*I have read and agreed to the above endorsement agreement:* Yes - I have read and agreed to the above endorsement agreement I also acknowledge and agree to the following: I am a person who is authorised to sign this application form on behalf of the Administrator; The Administrator agrees to comply with the requirements and obligations set out in this application form including the terms and conditions; On behalf of the Administrator, I have read and understood the application form in relation to the Summer Football Terms and Conditions; and On behalf of the Administrator, I have completed this application form to the best of my knowledge and ability and the contents of my submission are true and correct. Please Type Signature Here* Δ