Amigos Basketball Club Expression of Interest Form

Amigos Basketball Club

Banora Point Expression of Interest
PLAYER INFORMATION:
Name*

First NameLast Name
Birth Date*

DayMonthYear
Age turning in 2026
Address*

Street Address

Street Address Line 2

CityState

Post Code
Age Group Registering For:*
Primary Email Address (for correspondence from the Club)*
example@example.com
PARENT / GUARDIAN INFORMATION:

This will make you a member of Amigos Basketball Banora
1st Parent / Guardian Name*

First NameLast Name
1st Parent / Guardian Mobile Number*
1st Parent / Guardian Email Address *
example@example.com
2nd Parent / Guardian Name*

First NameLast Name
2nd Parent / Guardian Mobile Number*
2nd Parent / Guardian Email Address *
example@example.com
MEDICAL INFORMATION
Any medical conditions?

YesNo
Please list any medical conditions we should be aware of:
Player Basketball History
Tell us briefly any previous basketball experience:

What Competitions, Clubs, Associations you have played for and what Level you played at. Include Position, Current Height, Ability Level from 1 to 10 (10 being great, 1 a Beginner)
Experience etc.:
Thank you for registering your interest in joining Amigos Basketball Club Banora
Should be Empty:

Amigos Basketball Club