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Host Centre Application Form

Walking Football Host Centre Application Form

"*" indicates required fields

Football NSW has officially launched Walking Football programs in collaboration with FNSW Associations and Community Clubs. Walking Football programs are facilitated to provide male and female players the opportunity to continue playing or participate in football for the first time in a fun, sociable and inclusive environment.
Football NSW will develop sustainable and ongoing programs to encourage older people to make exercise a normal part of their routine
The program will highlight the health, wellbeing and social benefits of regular football and exercise activities for older people.

Association Name*

Club Name*

Approval of program from Member Association*

First Last

Please provide their name

Program Contact Name*

First Last

Program Contact Mobile Number*

Program Contact Email Address*

Program Contact WWCC*

Which day of the week does the program run?

If selecting more than one day, please hold the ctrl key on your keyboard while selecting your numerous day if applicable

What time will the program start?*

What time will the program finish?*

Program Location

Field Name*

Field Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Which of the following programs do you wish to run?*

50-65

65+

Date which program commences*

Date which program concludes*