GUB Camp Registration and Indemnity Form

All GUB Camp participants should complete both the online payment process AND this form to finalise their registration.

First Name(Required)

Last Name(Required)

Gender *(Required)

Date of Birth

Day

Month

Year

School(Required)

Current level of basketball participation? *(Required)

Parent details

First Name(Required)

Last Name(Required)

Parent Phone

Parent Email

Emergency Contact Name

First Name(Required)

Last Name(Required)

Emergency Contact Phone(Required)

Emergency Contact Relationship(Required)

Medical Notes

Please provide details of any medical conditions (including learning difficulties or behavioural issues, such as ASD, ADHD, etc) that our staff should be aware of.

Other Notes

Please detail the names (first and last) of any friend/s that your child would like to be grouped with on the day. You may also include any further details that may assist us to provide the best experience for your child.

Registration/Payment Completed by:

If your child was registered (paid) by someone other than the parent/guardian listed on this form, please advise, so we can match the completed indemnity form with the payment.

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