ALL-abilities Program Registration

(* required fields)

Surname*

First Name*

Date of Birth*

Gender

Are you new to Solway Basketball Club?

Are you transferring from another Club? (We will send you a clearance form that must be signed if you are transferring from another club)

What school do you attend?

Street*

Suburb*

Postcode*

Parent / Guardian #1*

Email*

Home Telephone*

Mobile* (in case of emergency)

Parent / Guardian #2

Home Telephone

Mobile (in case of emergency)

Payment Method*

NOTE: Please use Player's name as reference for EFT payments

Please add here any notes or additional information or requests, including any relevant behavioural or medical issues.

It may take a minute for the site to process this form
** DO NOT PUSH THE SUBMIT BUTTON MORE THAN ONCE **