Australian Basketball Services Logo, One On One & AND1 Basketball Camps
About Australian Basketball Services

specialist clinics

 

< back

Specialist Clinics 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
CLINIC VENUES AND DATES
 
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 clinic. I understand that the clinic organisers will make every effort to ensure the safety of my child. I will not hold them responsible for any injuries that occur during the clinic. Any photographs or images taken at the clinic may also be used by the organisers 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