SA Country Championships

SA Country Championships - Team Sheet

2025
Association *
Team Name*
Eg. D1M Barossa Valley Gold
Senior Country ChampsJunior Country Champs
Grade*

DIV 1 MenDIV 1 WomenDIV 2 MenDIV 2 WomenDIV 3 MenDIV 3 WomenDIV 4 Men
Grade*

U18 WomenU18 MenU16 WomenU16 MenU14 GirlsU14 BoysU12 GirlsU12 Boys
Division nominated*

DIV 1DIV 4DIV 2DIV 5DIV 3
Is this your first team?*

YesNo
What number team is this for this Age Group?

2345
As per the Country Championship By-Laws 8.2.1. Associations MUST nominate their ‘number 1’ (or best) team in Division 3 or higher in each age group.

If you wish to submit a Special Circumstances Request Form you can do so after you have nominated your team in Div 3 or higher. The Country Champs Sub Committee will assess each request as it is written and make judgement for what is best for the Country Championships.
Coach Name & Mobile*

Full Name Mobile
Coach Email
example@example.com
Assistant Coach Names

Assistant Coach 1Assistant Coach 2
Team Manager Name & Mobile*

Full Name Mobile
TM Email
example@example.com

Team list - All fields required *

	Playing #	First Name	Surname	DOB dd/mm/yy
1
2
3
4
5
6
7
8
9
10

Have any of the listed players competed in any of the following competitions?*

NBL1National ChampionshipsBSA DistrictAlbury/ Country CupNo
Player experience *
Has this team competed/Will this team compete in any Association Tournaments?*

YesNo
Murray Bridge CarnivalMillicent TournamentPort Augusta CarnivalBarossa Valley TournamentMount Gambier TournamentPort Pirie CarnivalWhyalla CarnivalRiverland CarnivalYorkers CarnivalNaracoorte Tournament
Main uniform colour*
Do you have an alternate uniform?*

YesNo
Alternate uniform colour
Would your team be interested in playing a game on Friday night 7th March?*

YesNo
Notes:

1. Only players listed on this team sheet and registered in Basketball Connect will be allowed to play in the Country Championships (CC). (Maximum 10 per team) subject to eligibility (refer By-Laws)

2. Played prior CC?- If a player has represented any Association at a previous Country Championship, please tick this box to assist us looking for players in the database

You must confirm whether or not junior players have played in U16 or U18 state teams in the previous year and/or a member of a SA Country U14-U18 junior development team.
Declaration:

I have read the Rules of Operation of the Championships and I am satisfied that all players fulfil the eligibility criteria of the Championships.
Are you the Association Secretary?*

YesNo
Association Secretary Name*
Association Secretary Signature*

Clear
Full Name
Role*
Association Secretary has verified this team listing and has read the SA Country Champions By-Laws
U18 Junior Country Championships team sheets MUST be submitted by 3rd November 2024.

Senior Country Championships team sheets MUST be submitted by 8th December 2024.

U12/U14/U16 Junior Country Championships MUST be submitted by 2nd February 2025.
Should be Empty:

SA Country Championships - Team Sheet