Membership Registration

Registration & Payment


Sample Club - Season 1, 2019

Membership Registration Form

(Click HERE to register for Junior Club)



SEASONAL MEMBERSHIP FEE

(U8-Miniball = $150, U10 = $200, U12-U18 = $250)

(10% discount off seasonal membership fee once you have 2 or more children to register)

Registration Fees covers administration End of Year Presentation.

If any player is under the age of 18 then "Parent(s) / Guardian(s) Details" must be completed.

Payment can be made via credit or debit card, cash or EFT to Sample Basketball Club

BSB 123456 Acc No. 12345678

(On all EFT payments please email payment confirmation to admin.SampleBasketball@gmail.com)



Season *


Player / Coach / Volunteer Registration

Given Name *
Surname *
Type of Membership *

Check all the boxes that apply to you.






Contact Information - must be completed in FULL

Preferred Email Address *

Email address to receive receipts, e-Newsletters, and etc.

Confirm email *
Preferred Contact Number (Mobile Phone) *
Address


Parent(s) / Guardian(s) Details - Primary Contact
(Please complete for players who are under 18)

Email Address (Cc) *

If you are adult and registering yourself, enter your own email address.

Given Name
Surname
Relationship
Preferred Contact Number

Mobile Phone, Home Phone, Work Phone, etc.


Fee Payment
(Please refer to the "Registration Info" webpage for the details.)

Seasonal Membership Fee (Games and Training) *
10% Discount off Seasonal Membership Fee

Get Started Voucher ?

Get Started Vouchers (up to the value of $150) - funding to help young people participate. Click on the link to check the eligibility and to apply for funding for your child Get Started Voucher.
https://www.qld.gov.au/recreation/sports/funding/getinthegame/getstarted/


Payment Method *

If you choose "Credit or Debit Card" as payment method, there is an extra fee charged by our Financial Services Provider for card payment(approximately 2.6%) and this will apply per each transaction.


Declaration

Declaration *

I/we consent to my children's details and/or my details being provided to the team manager and coach for the purpose of arranging games and training. I /We agree to abide by the rules and by-laws (refer www.businessname.com.au) of the Sample Basketball Club Inc. I/we am also aware the club singlets remain the property of the club and if they are damaged through inappropriate use I/we agree to pay the replacement cost.


Note to Administrator

Please let us know in advance if your child has any current medical conditions or injuries.

Security Number : .
Please enter this number.