Application for Membership Form Summer Season 2020
All forms to be returned no later than Tuesday 10th September 2019. Late returns may not be accepted.
*** If you are NOT playing next season a form must still be returned. *** *
Required
Player's Full Name *
Your answer
Address: *
Your answer
Telephone (Home): *
Your answer
Telephone (Mobile): *
Your answer
Email: *
Your answer
Date of Birth: *
Your answer
Gender: *
Required
Age: *
Required
Age Group - Under: *
(Born 2000/01 = U21; 2002-2004 = U19; 2005/06 = U16; 2007/08 = U14; 2009/10 = U12; 2011/12 = U10; 2013/14/15= U8)
Required
Please indicate here if Player would like to play a 2nd Game (2nd game would be in the next age group and would cost an extra $20 for the season)
Parent/Guardian details (Under 18 only)
Parent/Guardian 1 Name:
Your answer
Best Contact Number:
Your answer
*
Best Email Address:
Your answer
I am interested in coaching *
Required
Parent/Guardian 2 Name:
Your answer
Best Contact Number:
Your answer
Privacy
By accepting our Terms & Conditions you agree to the Club holding lists of family names, addresses, phone numbers and dates of birth. By including your email address you consent to the club sending you newsletters and game information by email. These will only be held by the Club Executive and committee members, and team coaches and managers. If you have any concerns please contact our Club Secretary.

Please be aware that your acceptance below also agrees for your child to play at Phoenix Basketball Club and that what grade your child plays and the team they are allocated to, is at the discretion of our Selection Committee. 
Note – This is an Application for Membership. It is not mandatory that the Club provide membership for your child.

Final teams, Coaches & Team managers will always be at the discretion of the Selection Committee and/or Club Committee. The Club Committee reserves the right to adjust, change or remove teams without notice.

Player/Parent Agreement (if child under 18) *
Required
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