MBUSC Sport Voucher Claim Form
The Sports Vouchers program is a Government of South Australia initiative administered by the Office for Recreation, Sport and Racing. The program provides an opportunity for children from Reception to Year 9 to receive up to a $100 discount on sport, dance and learn to swim fees. All South Australian children in Reception to Year 9 are eligible from 1 January 2024. This means if a child is 5 (or becoming 5 in the calendar year) to 15 years old are eligible. Remember it is one voucher for each eligible child per calendar year.
Child's Name
First Name
Last Name
Gender
Male
Female
Diverse
Date of Birth
-
Day
-
Month
Year
Address
Street Address
Suburb
City
State
Postcode
Medicare Number or Australian Visa Number
This is an 10 digit number.
Medicare Reference Number
Parent/Guardian's Name
First Name
Last Name
Parent/Guardian's Contact Number
Parent/Guardian's Email Address
An email address of the parent or guardian to inform them when the Sports Voucher has been processed.
Has the child used a Sports Voucher this calendar year?
Yes
No
Is this the first time the child is joining Soccer or Mount Barker United Soccer Club?
Yes
No
Has the child been identified as living with a disability?
Yes
No
Is the child from a Culturally and Linguistically diverse background (CALD)? e.g. Specific cultural or linguistic affiliation by virtue of their place of birth, ancestry, ethnic origin, religion, preferred language, language(s) spoken at home, or because of their parents’ identification on a similar basis.
Yes
No
Is the child identified as being an Aboriginal or Torres Strait Islander?
Yes
No
Total fee for playing season:
Submit
Should be Empty: