Please complete in full and send using the 'Submit' button at the bottom of the page.
An entry fee of £45 must be sent to: Geoff Yates, 5 Barnfield, Lostock Hall, PR5 5LD (01772 337457)

Team List (including captains) NB: Age Limits:16+Years with conditions all players under 18 years must notify league

Player Name: Mobile: