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One On One Girls Camps Registration Form
NAME

SCHOOL ATTENDED

AGE

PARENT / GARDIAN NAME

ADDRESS

STATE - IN AUSTRALIA

PHONE
( )
MOBILE

EMAIL

ANY MEDICAL CONDITION OR ALLERGY THAT OUR COACHES NEED TO KNOW ABOUT


CAMP DATE AND VENUE


PAYMENT DETAILS - Make cheques payable to Australian Basketball Services Pty Ltd.
Please contact me for payment details
A cheque will be posted to Australia Basketball Services

Condition to be acknowledged by parent / guardian. "I give permission for my son / daughter to attend the Basketball camp/clinic. I understand that the camp organizers will make every effort to ensure the safety of my child. I will not hold them responsible for any injuries that occur during the camp. Any photographs or images taken at the camp may also be used by the organizers for future promotional use."


OTHER ENQUIRIES / FEEDBACK

Australian Basketball Services Head Office

P.O. Box 4116 Balwyn East Vic 3103 Australia

Ph: 613 9348 1364 Fx: 613 9347 8762
info@ausbasketball.com.au

HEAD OFFICE (Melbourne)

P.O. Box 4116 Balwyn East Vic 3103 Ph: 613 9348 1364 Fx: 613 9347 8762