England Deaf Futsal

Squad TrialsTo register your attendance at the national trials, please complete and return this

page via the contact details provided.

Name: ___________________________________________________________

Address: _________________________________________________________

_________________________________________________________________

Date of Birth: ____________________ Age: _______________________

(Must be born on or before 26th April 1997)

Telephone Number: ________________________________________________

Mobile Number: ___________________________________________________

Email Address: _____________________________________________________

Current Club: ______________________________________________________

Do you have any previous experience of playing Futsal? ___________________

Preferred Playing Position:

Goalkeeper Defender Midfielder Forward

Relevant Medical Information: ________________________________________

Please return this form to:

Phil Heap via e-mail address: phil.heap@thefa.com before 12th April.

Your trial date will be confirmed week commencing 15th April.