Spring Basketball Camp Registration Form

Spring Basketball Camp Registration Form
Student Information
Student's Name

First NameLast Name
Date of Birth

DayMonthYear
Date
Year Level
Gender

MaleFemale
Does the student have any allergies or medical conditions? If yes, please describe.
Parent/Guardian Information
Name

First NameLast Name
Email
example@example.com
Mobile Number
Payment Information
Which days will your child be attending?

Monday 22nd September ($75)Tuesday 23rd September ($75)Both days ($120)
Please transfer payment to:

Account name: Pacific Basketball

BSB: 067873

Account no: 13798473

Description: Student's name
Should be Empty: