Holiday Basketball Camps
* PLEASE READ - DO NOT COMPLETE THIS FORM *

The latest holiday camps along with registration for them can now be found at www.bballcamps.juiceboxboy.com.au

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Participants Details
Please complete the following sections for EACH participant attending.
Participants Name *
Participants DOB *
MM
/
DD
/
YYYY
Affiliate Basketball Club (if applicable) *
School Attending *
If Other, please list your School Attending
Parents Name *
Parents Contact Number *
Parents Email *
Medical Conditions / Notes
Please selection which day(s) you are attending *
$55 per day per participant; select as many days as you wish to attend
Required
Playing experience *
Payment method *
How did you hear about us? *
Parent / Guardian Declaration
Please note that by submitting this registration you agree to the following. I the parent/guardian of the above named child give permission for him/her to participate in these clinics. In the event of any illness or incident where it is impractical to communicate with me, I authorize the organizer / coaches, on my behalf, to seek medical assistance as my child may require, including ambulance travel, anesthetic, blood transfusion and surgical procedures. I accept responsibility for payment of any expenses incurred. I acknowledge that my child may be injured in the course of the clinics and I understand and voluntarily accept the risk and agree that I will not hold the organizer / coaches to be liable for any injury including without limitation, personal, bodily or mental injury and economic loss. If there is any claim in relation to my child based on an injury, I agree to indemnify the organizer / coaches for all liabilities resulting from such claims. Any cancellations prior to the event will incur a $15 administration fee per registration. I agree to my child’s photo being used for promotional purposes.
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