ALL PLAYERS - CLUB REGISTRATION AND FEES

Modbury Basketball Club

ALL TEAMS AND COMPS

Club Registration and Fees

This form is to be used by current or new club members to register and play in the Modbury Basketball Club.

Modbury Basketball Club Fees are to be paid prior to season commencement.

ADDITIONAL TEAM FEES do not require you to register again, head directly to our website and pay the additional team fee there.

Basketball SA Fees must also be paid prior to any game play via GameDay - please speak to your coach or email us if you are unsure.

Refunds will only be issued on a case by case basis.

PLEASE NOTE: As of OCTOBER 2023 -

We No longer provide PAYMENT PLANS- AFTERPAY is availble.

If you have any questions, please contact the club on 0405109071 or email modburybasketball@gmail.com or accounts@modburybasketball.com

Competition Name *

Team Name *

New or Current Player*

Player Information

Player Name*

First NameLast Name

Player Date of birth*

Male or female*

MaleFemaleOther

Phone Number

Please enter a valid phone number.

Email*

example@example.com

Parent's Information (if participant is under 18)

Parent's/Guardian's name

Phone Number

Please enter a valid phone number.

Email

example@example.com

Emergency Contact 1 In the event of an emergency, please contact:

Name*

First NameLast Name

Relationship to player

Primary Phone Number*

Please enter a valid phone number.

Secondary Phone Number

Please enter a valid phone number.

Do you consent to photographs of yourself being used on social media?*

YesNo

Have you got Ambulance Cover?*

YesNo

Any medical conditions or Allergies to be noted?

Player Signature (Parent/Guardian if under 18*) *

By signing and submitting this form, you agree to the abide by the terms and conditions of the Modbury Basketball Club, available on our website. Refunds. Once you accept an offer to play for Modbury Basketball Club by completing your registration, then full fees will be charged, as per the above terms, even if you later decide not to play. Refunds will be prorated amounts based on games played and will only be given under exceptional circumstances for example, Medical – Medical reasons for the refund must be made via email to the Treasurer accounts@modburybasketball.com and will need to be substantiated by a Medical Certificate Relocation – May be applicable for families relocating to a residence outside of a 10 km zone from Tea Tree Gully Council. The refund application must be made via email to the Treasurer

School Vouchers

Do you intend to submit a School Voucher? Please note that the 2025 Sports Vouchers are available to all South Australian children from Reception to Year 9. Each eligible child can claim x 2 $100 vouchers per calendar year. School Vouchers must be submitted to Accounts@modburybasketball.com you will then be reimbursed once fees have been paid.

Fee Payment - Upfront or AfterPay?*

Club Fee Payments - New and Current Players. All Current players do NOT need to pay uniform fees.*

New Player Uniform Fee -MANDATORY FOR NEW PLAYERS

Mandatory Uniform Fee for all players. Once off Fee- this covers you for your uniforms while a player at the club. Please note: all uniforms must be returned upon leaving the club, or trading up to a bigger size. UNIFORM FEE IS A HIRE FEE

$80.00AUD

Club Membership Fees

for all players

$375.00AUD

Enter coupon

Total

$0.00AUD

Payment Methods

Credit Card

Apple Pay

Google Pay

Afterpay