Brisbane Capitals Junior Rep Trials 2015

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Player/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.

Player/Athlete Details

Male Female

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Parent/Guardian Details

Address

Health and Fitness

U12 Boys (2006/2007/2008)

Dates

From 13-Jun-2015 to 26-Jul-2015

Days & Times

Please select up to 2 sessions.
Once a time slot is full you will be asked to make another choice.

Saturday, 13-Jun-2015 05:00 PM to 07:00 PM NAB Stadium Crts 1 - 4 Under 18 - Males/Females
Sunday, 21-Jun-2015 08:00 AM to 10:30 AM NAB Stadium Crts 1 & 2 Under 18 - Males
Sunday, 21-Jun-2015 10:30 AM to 01:00 PM NAB Stadium Crts 1 & 2 Under 18 - Females
Sunday, 12-Jul-2015 08:00 AM to 10:00 AM NAB Stadium Crts 1 & 2 Under 14 - Females
Sunday, 12-Jul-2015 08:30 AM to 10:15 AM Kedron State High Under 14 - Males
Sunday, 12-Jul-2015 10:00 AM to 12:00 PM NAB Stadium Crts 1 & 2 Under 16 - Females
Sunday, 12-Jul-2015 10:15 AM to 12:00 PM Kedron State High Under 16 - Males
Sunday, 19-Jul-2015 08:00 AM to 10:00 AM NAB Stadium Crts 1 & 2 Under 14 - Females
Sunday, 19-Jul-2015 08:00 AM to 10:00 AM NAB Stadium Crt 3 Under 12 - Females
Sunday, 19-Jul-2015 08:30 AM to 10:15 AM Kedron State High Under 14 - Males
Sunday, 19-Jul-2015 10:00 AM to 12:00 PM NAB Stadium Crts 1 & 2 Under 16 - Females
Sunday, 19-Jul-2015 10:15 AM to 12:00 PM Kedron State High Under 16 - Males
Sunday, 19-Jul-2015 12:00 PM to 02:00 PM NAB Stadium Crts 1 & 2 Under 12 - Males
Sunday, 26-Jul-2015 08:00 AM to 10:00 AM NAB Stadium Crt 3 Under 12 - Females
Sunday, 26-Jul-2015 12:00 PM to 02:00 PM NAB Stadium Crts 1 - 4 Under 12 - Males

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

05-Oct-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.
$30.00
$30.00
Credit Card (Ezidebit)

2015 Rep Trials Questions

Will you be trialing with another association this season (2015/16)?
Yes
No
Which club have you been playing for during the Championship Season?
Lang Park
West Brisbane Falcons
Western Magic
North Brisbane Dragons
Vikings
BBC
Terrace/Brothers
Brisbane Grammar
St James
Other
If you answered "Other" please provide details:
Which Association did you last play representative basketball for?
Brisbane Capitals
Sunshine Coast Clippers
SunCoast RIP
Northside Wizards
Southern Districts Spartan
South West Pirates
Logan Thunder
Ipswich Force
Toowoomba Mountaineers
Gold Coast Waves
Runaway Bay SeaHawks
Other
If you answered "Other" please provide details:


If you played for an Association other than the Brisbane Capitals last year, please complete the following questions.
If you played for an Association other than the Brisbane Capitals, have you completed a "BQ Junior Player Permission to Train Form"?
Yes
No
If you played for an Association other than the Brisbane Capitals, have you completed a "BQ Player Transfer Form"?
Yes
No