Brisbane Basketball Incorporated

January 2020 All Girls Holiday Hoops Camp

Don't want to fill out this form online? Click here to download a printable PDF copy of this form

Group Bookings

How many people are there in your group?

Athlete 1

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If you do not have a username and password, one will be created for you when you submit this form.

Athlete Details

Athlete First Name

Athlete Last Name

Date of Birth

Gender

Male Female

Email Address

Confirm Email Address

Create your password

Enter the password that you would like to use for your new account.

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Home Phone

Mobile/Cell

Parent/Guardian Details

Mother's Name

Mother's Email Address

Mother's Mobile/Cell

Father's Name

Father's Email Address

Father's Mobile/Cell

Address

Address 1

Address 2

Suburb/Town

State/Prov

Zip/Postcode

Health and Fitness

Do you have any injury concerns?

Do you have any medical conditions?

Sport (if applicable)

Dates

From 01-Nov-2019 to 24-Jan-2020

Days & Times

Once a time slot is full you will be asked to make another choice.

Friday, 17-Jan-2020

09:00 AM

to 03:00 PM

NAB Stadium (Courts 1 - 4)

Concludes 3pm - Girls: Born 2002 - 2011

DISCLAIMER:
I hereby agree to assume all risks and responsibilities surrounding my (or my child's) participation in the program under the instruction of Brisbane Basketball Incorporated coaches. I understand that similar to all sporting activities, there is a risk of damage to personal property, injury or death which may result from causes beyond the control of, and without fault or negligence of Brisbane Basketball Incorporated, its officers, agents, or employees, during the period of my (or my child's) participation. I understand completely the above agreement and agree to be bound thereby. By registering on our site you agree that we may send you email related to our facilities and programs. We will not provide your details to any other company.

Agreement

I agree

Signed

Date

17-Apr-2024

Payment Method

There are no refunds for any enrolments into Brisbane Basketball Incorporated related programs. When you sign/tick confirmation for this enrolment you are acknowledging that you know this as a fact and have accepted it as a condition.

Cost

$70.00 Attend 1 Day (per session)

Cost Per Person

$0.00

Total Cost

$0.00

Group Discount

Promo Code

Promo Code Discount

Grand Total

Credit Card (Ezidebit)

Holiday Hoops Camps - Participant Tracking Question

1. Which Brisbane Basketball (BBI) Club are you currently playing for.

If you answered "Other" please provide details:

2. If you are not currently a member of BBI, would you like information on how to start playing in our Club Competition?

Yes, I would like further informaiton
No thank you
N/A

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