Registration Form

Registration & Payment

Membership Registration Form - Season 1, 2022

(Sunnybank Hills Hurricanes Basketball Club)

Player's Club Fee & SWM Annual Fee by Age Group


Age Group: Under 8

- Club Fee for Season 2, 2021: $200

- SWM Annual Fee: N/A


Age Group: Under 10 - Mixed Team

- Club Fee for Season 2, 2021: $200(returning player) / $250(new player)

- SWM Annual Fee (if not paid): $78.50 (approximate, Paid direct to SWM)


Age Group: Under 12 to Under 18 Boys & Under 12 to FYNL Girls

- Club Fee for Season 2, 2021: $240(returning player) / $290(new player)

- SWM Annual Fee (if not paid): $121.00 (approximate, Paid direct to SWM)


Training Only (Tuesday Skills Session) - All Age Group

- Club Fee for Season 2, 2021: $160

- SWM Annual Fee: N/A


FOR NEW PLAYERS, THE CLUB FEE INCLUDES TEAM SHORTS WHICH IS MANDATORY TO BE PURCHASED. (Under 8 and Training Only are not required to wear Hurricanes shorts therefore shorts are not included in fees)


*** Hurricanes Club fees are payable by cash, cheques or direct deposit into club's banking accout.

- Bank: Bank of QLD

- BSB Number: 124-001

- Account Number: 10410429


*** SWMBI registration is only available on-line, please go to piratesbasketball.net.au for further details. (Failure to register with SWMBI will result in games forfeited by the association.)


* Required

Season *


Basic Info (Player / Tranining only / Volunteer)

Type of Membership *

(Please tick all the boxes that apply to you. Training only option consists of Tuesday Skills training only.)







Given Name *
Surname *
DOB *
dd/mm/yyyy (e.g. 15/01/2015)
Gender *


Preferred Email *

Email Address to receive emails from the club

Confirm email *
Preferred Contact Number (Mobile Number) *
Address *

(House number, Street, Suburb and Postcode)


Player Information

(* Required only for "Player")

Are you new to Hurricanes as a "Player" ?

If you have done skills(Training only) from Hurricanes last season and new to the competition, select "Yes, I am a beginner".





SWM Clubs the athelete previously played in








Previous Division (Highest played in 2021)




Player's Jersey Size

(Hurricanes will supply team singlets to all age groups. So we need to know the player's jersey size)

Player's Shorts Size

(* Required for new Players only, not for returning Players)

Is the athlete interested in a personalised jersey? (extra cost)



Parent/Guardian Details
(* Requied for anyone under 18 years of age)

Parent/Guardian's Email (Cc)
Parent/Guardian's Given Name
Parent/Guardian's Surname
Parent/Guardian's Mobile Number
Parent/Guardian's Address

(House number, Street, Suburb and Postcode)

Duty of Scoring

(* Required only for "Player")
Please understand that at Hurricanes it is the responsibility of every family to help on the score bench. If you don't know how to score or have never dont it before, we will allocate an experienced parent to sit beside you to assist. If you do not wish to score, there will be a small fee of $20 per season, usually payable to an older child or sibling who would score on your allocated weeks.





Emergency Information

(* Requied for anyone under 18 years of age)

Emergency Contact Name
Relationship
Mobile Number
Alternative Number

(Home Phone, Work Phone, etc)

Does the athlete have any allergies, chronic illness or medical conditions?

(If yes, please describe. If No, please write None.)

Is the Athlete prescribed an inhaler? If yes, Please explain any instructions.



Club Fee Payment

(* Required only for "Player" and "Training only")

Age Group
School Grade (this year)


FairPlay Voucher (Formerly Get Started Voucher)

FairPlay Voucher (up to the value of $150) - funding to help young people participate. Click on the link to check the eligibility and to apply for funding for your child FairPlay Voucher.

https://www.qld.gov.au/recreation/sports/funding/getinthegame/getstarted/

Are you going to use the voucher this season?


If you have a voucher, please enter number.

(* Required if you use a FairPlay voucher. Please enter "TBA" if you don't have a voucher yet.)

Payment Method

If you choose "Credit or Debit Card" as payment method, there is an extra fee charged by PayPal for card payment(approximately 2.6%+$0.30) and this will apply per each transaction.


Declaration & Authorisation

Please read the declaration below. The check boxes below represent your electronic acceptance and authorization.


Informed Consent and Acknowledgement

1. I abide by the rules and by-laws of Sunnybank Hills Hurricanes Basketball Club Inc and South West Metro Basketball Inc.;


2. I give permission to Sunnybank Hills Hurricanes Basketball Club Inc. to use my email address in a bulk mail which will be forwarded to other Hurricanes members for purposes of game notification and other relevant club information;


3. I or my child may be photographed and grant Hurricanes Basketball Club the right and permission to use and publish the photographs without limitation across all media sites (printed or electronic) for the promotion of Sunnybank Hills Hurricanes Basketball Club and I hereby release Sunnybank Hills Hurricanes Basketball Club from any and all liability from such use and publication;


4. I will be responsible for any damage to property and equipment caused by me or my child and pay for such damage on demand;


5. I acknowledge that I am aware that there will only be limited times when a person qualified in First Aid is present;


6. I advise my child has the listed medical conditions (above) including allergies and warrant that my child is fit to play basketball and will notify the club should any new medical information become available.


Informed Consent and Acknowledgement

I hereby give my approval for my child’s participation in any and all activities prepared by Sunnybank Hills Hurricanes during the season. In exchange for the acceptance of said child’s candidacy by Sunnybank Hills Hurricanes, I assume all risk and hazards incidental to the conduct of the activities, and release, absolve and hold faultless Sunnybank Hills Hurricanes and all its respective officers, agents, and representatives from any and all liability for injuries to said child arising out of traveling to, participating in, or returning from selected camp sessions.


In case of injury to said child, I hereby waive all claims against Sunnybank Hills Hurricanes including all coaches and affiliates, all participants, sponsoring agencies, advertisers, and, if applicable, owners and lessors of premises used to conduct the event.

There is a risk of being injured that is inherent in all sports activities, including basketball. Some of these injuries include, but are not limited to, the risk of fractures, paralysis, or death.


Medical Release and Authorisation

As Parent and/or Guardian of the named athlete, I hereby authorise the diagnosis and treatment by a qualified and licensed medical professional, of the minor child, in the event of a medical emergency, which in the opinion of the attending medical professional, requires immediate attention to prevent further endangerment of the minor’s life, physical disfigurement, physical impairment, or other undue pain, suffering or discomfort, if delayed.


Permission is hereby granted to the attending physician to proceed with any medical or minor surgical treatment, x-ray examination and immunisations for the named athlete. In the event of an emergency arising out of serious illness, the need for major surgery, or significant accidental injury, I understand that every attempt will be made by the attending physician to contact me in the most expeditious way possible. This authorisation is granted only after a reasonable effort has been made to reach me.


Permission is also granted to the Sunnybank Hills Hurricanes and its affiliates including Directors, Coaches, and Team Parents to provide the needed emergency treatment prior to the child’s admission to the medical facility.

Release authorised on the dates and/or duration of the registered season.

This release is authorised and executed of my own free will, with the sole purpose of authorising medical treatment under emergency circumstances, for the protection of life and limb of the named minor child, in my absence.


Confirmation

BY ACKNOWLEDGING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.

Parent/Guardian's Authorisation to Sign Up *

As a parent/guardian, I acknowledge and authorize that the above player is signing up to the Sunnybank Hills Hurricanes Basketball Club. I also acknowledge that as a Parent/Guardian, I will be requested to perform score table duties from time to time.


Parent/Guardian's Confirmation *

As a parent/guardian, I acknowledge that I have read all the information and accept the declaration above. I confirm that the information filled in this form was filled by an individual over the age of 18 and is filled out to the best of my knowledge representing true and correct information.


Note to Administrator
Security Number : .
Please enter this number.