Child Details
Child Full Name
*
Child first name
Child surname
Child Gender
*
Please Select
Female
Male
Child date of birth
*
-
Day
-
Month
Year
Date
Street Address
*
Suburb
*
Postcode
*
Australian Visa Number
11 digits
Medicare number
*
Must be 10 digits FOLLOWED by place number on medicare card
Parent/Carer Giver Details
Parent Full Name
*
Parent first name
Parent surname
Parent contact number
*
Parent email
*
example@example.com
Eligibility to Claim
All South Australian children in Reception to Year 9 are eligible. This means if a child is 5 (or becoming 5 in the calendar year) to 15 years old are eligible. Remember it is one voucher for each eligible child per calendar year.
First time joining this organisation?
*
YES
NO
Identified as living with a disability?
*
YES
NO
Aboriginal or Torres Strait Islander
*
YES
NO
Is English the main language spoken at home?
*
YES
NO
If no, what language do you speak at home?
Cost to register for this activity
*
ie what does the competition you are claiming for cost for a season (MUST BE A WHOLE NUMBER)
What competition are you claiming for?
*
Please Select
SAJBL - South Australia Junior Basketball League
Bank Account Details
Please enter your bank account details you would like your refund paid to. Please note Player Fees are required to be paid in full. Sports Voucher refunds will be processed once funds are received from the Government of South Australia.
Bank BSB
*
Bank Account Number
*
Bank Account Name
*
Submit
Should be Empty: