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Registration & Payment

Sample Basketball Club Inc.

Membership Form


Important Note Before You Start (example):

For insurance purposes all players MUST be registered with South West Metro Basketball Association and be financial members of the Sample Basketball Association. SWM have registration fees ($72-$110) in addition to the Sample Basketball Club fees. The Association will revoke game points for any team fielding unregistered players. It is a requirement that all players have their OWN club shorts for games. If you do not wear the uniform, points are added to the opposition's score.


Fee Structure based on DOB for Seson1, 2019 (example)

Under 8 Miniball (Born 2012 or after) - $30

Under 10 (Born 2010 or 2011) - $180

Under 12 (Born 2008 or 2009) - $210

Under 14 (Born 2006 or 2007) - $210

Under 16 (Born 2004 or 2005) - $210

Under 18 (Born 2003 or before) - $210


* Required

Season *

Player Details

Surname *
Given Name *
D.O.B *

dd/mm/yyyy or YYYY-MM-DD (e.g. 15/01/2015 or 2015-01-15)

Gender *
F
M
Contact Email *
Confirm email *
Contact Number *
T-Shirt Size *
Membership *

Existing = Played Season 1 2015

Existing
New
Returning after a break
Transfer
SWM_Rep

Has player ever played Rep? If currently playing in 2014/15 season, please select team. If not currently playing rep but has previously, please indicate year played (tottom of list).

Family / Guardian(s) / Parent(s) Details

Primary Contact_Surname *
Primary Contact_Given Name *
Primary Contact_Email (Cc) *
Primary Contact_Phone *
Secondary Contact_Surname
Secondary Contact_Given Name
Secondary Contact_Email
Address_Street
Address_Suburb
Photography *

I/we consent to my children's photos being taken at basketball games and/or training to be displayed on the club website.

Yes
No

Membership Fee Payment

Payment Method *

What is your preferred payment method for River City Hornets fees?

Credit or Debit card
Electronic funds transfer (EFT)
Cash
Get Started Voucher ?

Please check if you use the voucher. If you need information about the voucher, refer https://www.qld.gov.au/recreation/sports/funding/getinthegame/getstarted/

I will send you the voucher.
Payment_Date

If you have already paid season fees please advise date? (dd/mm/yyyy)

SWM_Rego *

Is player registered with South West Metro Basketball Association?

Yes
No
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.

Agree
Additional Information

Never submit passwords through this forms.



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