Meadowbank Skills - Junior Basketball Academy

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JBA Camp Location

Player's Name*

Player's First Name Player's Last Name

Gender*

Age*

Please select the class that your child will attend:*

Ages 5-8: Saturday 12:00pm-1:30pm
Ages 9-11: Saturday 1:40pm-3:10pm
Ages 12-14: Saturday 3:20pm-4:50pm

To help us in making sure your child has the best experience at our classes, can you please select the best description of their current experience or skill level:*

How did you hear about us?*

Returning Player
Facebook
Google
School
Referral
Flyer

Postcode*

Name of School*

Parent's Name*

First Last

Email*

Emergency Contact Name*

Emergency Contact Number 1*

Any physical, mental health, allergies or other condition that could require special attention or medication?

Special Requests or Notes (Please let us know anything else that you would like us to be aware of)

Active Kids - Submit Vouchers

If you would like to use the Active Kids Voucher for this camp, please enter the voucher number and use JBA code ‘ACTIVE2020’ before checking out to auto-deduct $50 off the cost of the camp.

Steps:

1. Enter your child's name, Active Kids voucher number and DOB (Please double check that the voucher number and DOB are accurate and have only been redeemed once)
2. Enter JBA code 'ACTIVE2020' and click the 'Apply' button to have the voucher redeemed
3. The payment cart will automatically have $50 removed from the total

Child's Name (as written on voucher)

Voucher Number

Enter the 16-digit number without spaces or symbols

Activation Code

Date of Birth

I do hereby waive and release any and all rights and claims for damages that may have or hereinafter occur to me against the director and staff of Junior Basketball Academy (JBA). I confirm that my child’s health meets medical standards to participate in a basketball class. I understand that basketball is a sport, and injuries may occur. I further understand that, neither the class director nor any staff of JBA shall be held responsible for any medical injuries that may result from participation in the Junior Basketball Academy skills class and games. I give permission for my son/daughter to participate in the JBA class, and I give the director and the staff of JBA my permission to act on my behalf in arranging for emergency medical attention to the above mentioned camper from a licensed physician or hospital if necessary. The undersigned parent/legal guardian of the above mentioned applicant has read and understands the above agreement, and accepts and agrees to the terms and conditions of this waiver/release form.*

I agree

Our classes are designed to offer a fun and safe experience for all participants. We believe in the importance of good sportsmanship and respect for other participants, coaches, equipment, the venue and their staff. We do not tolerate bullying, bad language/swearing, fighting or overly rough play. I agree that JBA reserves the right to ask a participant to leave the skills class without refund if fairly warranted in the best interests of the experience of the other participants.*

I agree

I give permission and consent to allow photographs and video to be taken during class session activities. I further give permission and consent that any such photographs and video may be published and used by Junior Basketball Academy and its coaches, to illustrate and promote the class experience and program.

I agree

I have read and agree to the JBA Terms and Conditions including the sections regarding eligibility, behaviour, pick up times, refunds and cancellations*

I have read and agree to the JBA Terms and Conditions including the sections regarding eligibility, behaviour, pick up times, refunds and cancellations *

I agree

Payment Details

PLEASE SELECT YOUR START DATE (totals are pro-rated):

Total

$ 0.00

Credit Card

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