Maynooth Town FC Academy Registration Form

Block 1 Season 2016/2017 Starting August 26th

59 for the 10 Weeks if you have Completed more than 4 Terms
69 Due for less than 4 Terms
Please contact Ciaran on 089-439 6114 if you have any questions

Reregistration Form
1 Form per Family
Outline New Selection Age Group
We will have 3 Groups on Fridays under new times going forward

Junior Strikers Ages 4 to 6 Operating Time 5.30 to 6.30

Senior Strikers Ages 7 to 8 Operating Time 6.00 to 7.00
Galcticos Ages 9 to 16 - 6.00 to 7.15 Friday

previously 6pm group

previously 7pm group
previously 8pm group

Email Address: ___________________________________________________ _______block capitals please

Blocks Completed

Registration form required for all players, Siblings complete Side by Side

Name:
DOB:
Address:
Boy

Guardian Personal Data

Name:
Address: if different
Contact Number:

___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
Girl
( please tick Box )

_________________________________________________
_________________________________________________
_________________________________________________

Football Data

Team Manager Name: __________________________________________

Position Preference: _______________
Registered with Maynooth Town FC in 2016/2017 Yes
or No

Free Shorts & Socks XX Small

XS

Club & Academy Director of Coaching:

Academy Director & Club Board Member:

Small

Medium

Large

Ciaran Quinn
Paul Brogan