Team All Abilities

Ballers Haven Basketball

REGISTRATION FORM

Term 2 – Winter Season 2025
28 July – 2 Oct 2025

First Name

Age

Last Name

Date of Birth

Preferred Name

Gender

BASKETBALL PROGRAMS

BASKETBALL PROGRAMS

Team Foundations (Beginners level): For ballers who are new or at the early stage of learning how to play basketball. (7 – 11 years old) Team All Girls (Beginners level): For girls who are new or at the early stage of learning how to play basketball. (7 – 12 years old) Team Rookies (Intermediate level): For ballers who would like to enhance their fundamental skills in basketball. (12 – 15 years old) Team Ball Abilities (Recreational): For kids living with autism who would like to improve their coordination, communication & social skills

PARENT OR GUARDIAN’S DETAILS:

Parent First Name

Relationship

Parent Last Name

Contact Number

BALLER’S MEDICAL BACKGROUND: (Confidential)

Health condition or previous injury: (if relevant)

First aid or safety strategies:

How can we help encourage full participation?

Consent to take Photos & Videos, Waiver of Liability and Declaration of Parent or Guardian:

I give Ballers Haven Basketball Club Inc. permission to take photographs and/or videos of my child (baller) and the right to use them in their printed materials such as but not limited to banners & flyers, and online publicity such as but not limited to their website & social media accounts. I hereby understand and acknowledge that the training, games and events held by Ballers Haven Basketball Club Inc. may expose my child (baller) to many inherent risks, including accidents, injury and illness. I agree, for myself and anyone entitled to act on my behalf to hold harmless, waive and release Ballers Haven Basketball Club Inc., its coaches, employees, volunteers, representatives, and successors from any responsibility, liabilities, demands, or claims of any kind arising out of my child’s (baller) participation in training, games and events held by Ballers Haven Basketball Club Inc. and I voluntarily agree to these terms. I hereby declare that the information I provided are true and correct.

Ballers Haven Basketball

Team All abilities

Coach Jerry on 0430 396 790 |

info@ballershavenbasketball.com.au |

Ballers Haven Basketball Page

REGISTRATION FORM