Wits Futsal Fives League
Registration Form - 2016
Teams have a max of 10 players. Games will be played at Wits Futsal Courts, Wits University, West Campus. Register NOW!!!
Bring your teams and take part in The Wits Futsal Fives League!
Futsal is the only 5 a side football game recognised by FIFA.
The game is played with a special ball that is designed to have less bounce, which encourages passing, individual skills and team play while maximizing active participation of all players.
Wits StudentsR1000 per team – Includes a ball
Corporate RateR2500 per team – Includes a ball
Court Hire Rates:
Wits StudentsR150 per hour
Corporate RateR350 per hour
For more info - Email Bevan Fenner at or call 011 717 9436/082 381 5627
Please ensure this form is fully completed and each individual Player/Parent/Guardian has signed where applicable.
Wits Futsal Fives League Registration Form
Team Name______Team Manager/Coach/Representative Name______
Home Tel:______Work Tel:______Mobile:______
Wits Futsal Fives League Waiver & Release
10 Player team roster. Each individual player’s signature or parent’s signature if player is a minor MUST be on the roster.Player’s Name / Player’s Surname / DOB / Mobile Number / Parent/Guardian’s signature, if player under 18 years of age
Methods of Payment
- EFT/Cash deposit - Email proof of payment to
- Debit Card - Payments must be made at the Wits Sports Reception/Wits Futsal Office, Sturrock Park.
- Cash – Payments must be made at the fees office.
NB. No cash payments will be taken at the Wits Sports Reception
Account Name: Wits Sundry Debtors
Bank: FNB – Braamfontein Branch
Account Number: 62077141580, Reference: Wits Futsal 25165
Cancellation clause, seven (7) days from date of signature as per the consumer protection act.
Wits Futsal is committed to conducting its recreation programs and activities in a safe manner and holds the safety of participants in high regard. Wits Futsal continually strives to reduce such risks and insists that all participants follow safety rules and instructions that are designed to protect the participants’ safety. However, participants and parents/guardians of minors registering for this program must recognize that there is an inherent risk of injury when choosing to participate in recreational activities. You are solely responsible for determining if you or your minor child is physically fit and/or adequately skilled for the activities contemplated by this agreement. It is always advisable, especially if the participant is pregnant, disabled in any way or recently suffered an illness, injury or impairment, to consult a physician before undertaking any physical activity.
I understand that my child or I may be photographed or videotaped while participating in a Wits Futsal program. I give permission for photos and videotapes of my child or me to be used to promote the game of Futsal. Such photos and videotapes will remain the property of Wits Futsal.
WARNING OF RISK Football is intended to challenge and engage the physical, mental and emotional resources of each participant. Despite careful and proper preparation, instruction, medical advice, conditioning and equipment, there is still a risk of serious injury. All hazards and dangers cannot be foreseen. Because football is a contact sport played with little or no equipment and because it puts great demands on stamina, the very nature of the game of football is hazardous and risky. Such risks and dangers include, but are not limited to, acts of kicking, heading and fielding the ball, colliding with other players or stationary objects, being struck by errant balls, running, jumping, stretching, sliding, diving, acts of God, inclement weather, inadequate or defective equipment, failure in supervision or instruction, poor officiating, unsportsmanlike conduct, dangerous or defective playing conditions such as rocks or holes on or off the playing surface, seams or tears in the Futsal surface, incorrect footwear in poor weather conditions, horseplay, carelessness, and all other circumstances inherent to sport of football. In this regard, it is impossible for Wits Futsal or Wits University to guarantee absolute safety.
WAIVER AND RELEASE OF ALL CLAIMS AND ASSUMPTION OF RISK Please read this form carefully and be aware that in signing up and participating in this program/activity, you will be expressly assuming the risk and legal liability and waiving and releasing all claims for injuries, damages or loss which you or your minor child might sustain as a result of participating in any and all activities connected with and associated with this program/activity (including transportation services and vehicle operations, when provided). I recognize and acknowledge that there are certain risks of physical injury to participants in this program/activity, and I voluntarily agree to assume the full risk of any and all injuries, damages or loss, regardless of severity, that my minor child or I may sustain as a result of said participation. I further agree to waive and relinquish all claims I or my minor child may have (or accrue to me or my child) as a result of participating in this program/activity against Wits Futsal or Wits University, including its officials, agents, volunteers and employees.
I have read and fully understand the above important information, warning of risk, assumption of risk and waiver and release of all claims. If registering on-line or via fax, my on-line or facsimile signature shall substitute for and have the same legal effect as an original form signature. Parents and/or guardians must sign swaiver if player is under 18 years of age.