Brisbane Basketball Incorporated

July 2020 Holiday Hoops Camps (Boys & Girls)

Group Bookings

How many people are there in your group?

Player/Athlete 1

Player/Athlete Details

Player/Athlete First Name

Player/Athlete Last Name

Date of Birth

Gender

Email Address

Confirm Email Address

Create your password

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

Confirm your password

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)

Training Dates

From 06-Jul-2020 to 10-Jul-2020

Training Days & Times

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

Monday, 06-Jul-2020	09:00 AM	to 03:00 PM	BBI, 16 Dixon St, Auchenflower QLD 4066	Boys & Girls: Born 2005 - 2014
Tuesday, 07-Jul-2020	09:00 AM	to 03:00 PM	BBI, 16 Dixon St, Auchenflower QLD 4066	Boys & Girls: Born 2005 - 2014
Thursday, 09-Jul-2020	09:00 AM	to 03:00 PM	BBI, 16 Dixon St, Auchenflower QLD 4066	Boys & Girls: Born 2005 - 2014
Friday, 10-Jul-2020	09:00 AM	to 03:00 PM	BBI, 16 Dixon St, Auchenflower QLD 4066	Boys & Girls: Born 2005 - 2014

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

Signed (Parent/Guardian)

Date

/ /

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)
$125.00 Attend 2 Days
$180.00 Attend 3 Days
$240.00 Attend 4 Days

Cost Per Person

$0.00

Total Cost

Group Discount

Promo Code

Promo Code Discount

Grand Total

Credit Card (Ezidebit)

Please mail this form with a payment attached to: "Brisbane Basketball Incorporated, Auchenflower Stadium 16 Dixon Street,, Auchenflower Queensland 4066"