Spartans Neurodiverse - Come and Try Expression of Interest
Register your interest to join a Spartans Neurodiverse 'Come and Try' session. Please fill out your details below.
Participant's Full Name
*
First Name
Last Name
Participant's Date of Birth
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Parent/Guardian Name (if under 18)
*
First Name
Last Name
Relationship to participant
*
Email Address
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Gender
*
Male
Female
Basketball Experience
*
No experience
Some school or social basketball
Played for a club before
Other
Medical Conditions / Support Needs
*
Emergency Contact Name
*
First Name
Last Name
Emergency Contact Phone
*
Please enter a valid phone number.
Format: (000) 000-0000.
Submit Expression of Interest
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