Ausome Hoops Mornington Term 2
Sunday's 9:45am - 10:30am at Mornington Civic Reserve - 4th May - 29th June (NO SESSION 8 JUNE)
Name
*
First Name
Last Name
Gender
*
Date of Birth
*
-
Day
-
Month
Year
Date
Email
*
example@example.com
Is this your child's first term in Ausome Hoops?
Please Select
Yes
No
Participant NDIS Number
*
For Invoicing Purposes
Please help us get to know your child! (e.g. favourite things, likes/dislikes)
Medical Information
Does your child have any of the following
Asthma
Diabetes
Allergies
Epilepsy
Other
If Other was selected, please state:
Does your child use any regular medication?
Yes
No
If Yes was selected, please provide details
If you have selected 'Yes' to either Asthma or Allergies you must submit an Asthma or Allergy Management Plan. Participants will not be permitted to play until this information has been submitted
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Consent to Medical Treatment
I authorise officials, coaches and team managers to obtain for my child any necessary medical treatment by appropriate medical practitioners in the event of injury in my absence and where impractical to communicate with me. Should it be necessary to call an ambulance for my child, I accept full responsibility for any cost incurred.
Signature
*
Media Consent
I give permission to Ausome Hoops and Mornington Basketball to take photographs and videos of my child during sessions for use of Social Media and for Marketing purposes.
Media Consent:
*
Yes
No
Signature
Contact Details
Contact Name 1
*
First Name
Last Name
Contact Number 1
*
Contact Name 2
First Name
Last Name
Contact Number 2
Basketball Jerseys
As part of Peninsula Speech Plus' sponsorship, all new participants in our Term 3 program will receive a customised Ausome Hoops Basketball Jersey. Please see below for the sizing guide. PLEASE NOTE - singlets take 6 weeks to be produced and shipped. The order is placed within the first few weeks of the term.
Size
Please Select
6Y
8Y
10Y
12Y
14Y
XS
S
M
L
XL
Name/Nickname:
Name/Nickname wanted on jersey
Number
Number wanted on Jersey
Payment
We have flexible payment options available. Please email director@ausomehoops.com.au to discuss.
My Products
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Ausome Hoops Mornington Term 2
9:45am - 10:30am 4/05/2025 - 29/06/2025
$
365.00
AUD
Payment Methods
Credit Card
Apple Pay
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