St Agnes Ladies Tournament

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taken photos on

Club / Team Name

Which League do you currently Play in? *

Age Group *

Your Name *

First

Last

Manager Email *

Manager Contact Number *

Do you consent to having photos taken on the day for use on our social media pages and website? *— Select Choice —YesNo

Have you paid entry fees by Bacs *

• Yes
• No

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Bank Details
Account Name: St Agnes AFC
Sort Code: 20-87-94
Account No: 33081745
Please leave your club / surname as a payment Reference