Team Registration Form
Amputee Football World Cup 2009

For Your Team to Play, We MUST Receive This Inscription Form No Later Than 25 August 2009

Your Name:


Your Country:


Your E-mail Address: (* Required)



A team from my country will participate in the Amputee Football World Championships in Brazil, September, 2009.
   Yes        No        Undecided


A delegate from my country will participate in the World Amputee Football Federation Congress in Brazil, September, 2009.
   Yes        No        Undecided


The Players on my team are: (No more than 12 Players)
List player name, jersey number, and position


Name of Coach


Name of Sub Coach (Assistant Coach)   


Name of Team Manager   


Name of Doctor of Physiotherapist   


Name of Referee   


Name of your Official Delegate who is authorized to vote for your country in the WAFF Congress   


Your Comment, Question or Message: