• BASKETBALL CLINIC FUNDRAISER REGISTRATION

    Register for the Basketball clinic fundraiser supporting the under 18 girls representative team. Please review the event detail details complete their required participant and guardian information and arrange payment at checkout
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  • Participants Details

  • Parent / Guardian Details

  • Medical Disclosure

  • Does the player have any medical conditions, injuries, allergies, medications or additional support requirements that may affect their safe participation?*
  • Basketball Queensland Registration Details

  • Does the player currently hold an active Basketball Queensland registration?*
  • REGISTRATION, INSURANCE AND PARTICIPATION ACKNOWLEDGEMENT

  • This fundraising activity is being administered through Jotform rather than Basketball Connect. The attendance fee covers participation in this activity only. It does not include Basketball Queensland registration, affiliation fees or the purchase of Basketball Queensland insurance. Completing this form and paying the attendance fee does not create Basketball Queensland insurance coverage. Players who already hold a current and active Basketball Queensland registration may be eligible for insurance benefits, subject to the applicable insurance policy’s eligibility requirements, terms, exclusions and benefit limits. GSBA cannot guarantee that any insurance claim will be accepted.

  • CONSENTS AND ACKNOWLEDGEMENTS

  • Photo/Video Consent*
  • I understand that basketball and related physical activities involve inherent risks, including accidental injury. I understand that GSBA will take reasonable safety precautions; however, not every risk can be eliminated. I accept responsibility for medical, treatment and associated expenses that are not covered by Medicare, private health insurance, Basketball Queensland insurance or another applicable insurance policy. Nothing in this acknowledgement excludes or limits any rights or liabilities that cannot lawfully be excluded.

  • PAYMENT

  • Payment*

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      Basketball Clinic Registration

      Clinic registration payment

      $30.00 AUD$30.00AUD
      Age Group Quantity Price
      Ages U8 $30.00 AUD$30.00AUD
      Ages U10 $30.00 AUD$30.00AUD
      Ages U12 $35.00 AUD$35.00AUD
      Ages U15 $35.00 AUD$35.00AUD

      Item subtotal:$0.00 AUD$0.00AUD
        
      Total
      $0.00 AUD$0.00AUD

      Payment Methods

      creditcard
      After submitting the form, you will be redirected to Apple Pay to complete the payment.
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