D-League SURFCOAST
D-League Basketball Registration Form
Christian College Campus- 248 Great Ocean Rd, Torquay VIC
Name
First Name
Last Name
Parents Details
First Name
Last Name
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Email
example@example.com
Athlete D.O.B
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
D-League Academy Session- Warm up- Fitness- Skills- Game situation
Saturdays 8.30-9.30am Christian College Jan Juc U10s-12s $20pp
Saturdays 9.45-11.00am Christian College Jan Juc U12-18s $40pp
Do YOU have a Medical Condition that may be impacted by attending our sessions?
I acknowledge that I am responsible for the medical care of myself and/or my child/attendee, including providing any required medications. I understand and agree that D-League is not responsible or liable for any medical events or injuries that occur before, during, or after participation in D-League programs.
Submit
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