Registration & Payment

Event Participation - Taiwan 2024

Season 2, 2024 (September)



* Required

Event *


Basic Info (Player / Coach / Manager / Traveling adult)

Membership Type *




Given Name ON PASSPORT *

Please ensure spelling of name matches passport details to avoid additional charges when flying.

Surname ON PASSPORT *

Please ensure spelling of name matches passport details to avoid additional charges when flying.

DOB *
Gender *


Preferred Email Address *
Confirm email *
Preferred Contact Number (Mobile Phone) *
Alternative Contact Number

Mobile Phone, Home Phone, Work Phone, etc.

Address *
Suburb *
Post Code *


Passport Info

Passport Number *
Passport Issuer (country) *
Passport expiry *

Date of Expiry (e.g. 15/10/2023)


Emergency Contact

(* Requied for all participants)

Given Name *
Surname *
Relationship *
Email Address (Cc) *
Preferred Contact Number *


Parent/Guardian Details

U16 must complete
Given Name
Surname
Relationship
Email Address
Preferred Contact Number

Mobile Phone, Home Phone, Work Phone, etc.


Participation Fee & Age Group

Membership Type & Participation Fee *
Age Group *
Payment Method *

Payment = Staged Payment

Date

Amount

Status

07/07/2024

$500.00

Deposit

21/07/2024

$800.00

Payment1

04/08/2024

$800.00

Payment2

18/08/2024

$750.00

Payment3

24/09/2024


Departure

TOTAL

$2,850.00


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


[Banking Details for EFT]

Bank Name: Bank of Queensland

BSB: 124001

Account Number: 22964356

Account Name: Runcorn Rockets

Include R# in payment details

(Please send evidence that you have paid to treasurer@rocketsbasketball.com.au.)


Declaration

Player Declaration / Parent Consent *

Player's Declaration

I, Hereby agree as follows:

● I have confirmed the emails entered are correct and that I will read all emails and attachments sent to me in relation to this excursion.

I am aware that the Runcorn Rockets Basketball Club Inc does not have personal accident insurance cover for players/coach/manager/other participants (“Travellers) and will ensure I have taken out travel insurance for the duration of the trip.

I give consent for the player/traveller named in this application to participate in the excursion.

I will pay to Runcorn Rockets Basketball Club Inc the costs detailed in this registration for the player/Travellers in the excursion on the due dates indicated. I understand that failure to do so could see the player/Travellers removed from the excursion without refund.

I agree to and understand the refund policy as it applies to this excursion – no refunds from 1st July 2024 but you do have the ability to transfer your payment to another Travellers less any change of name fees that apply.

In the event of an accident or illness, Runcorn Rockets Basketball Club Inc committee members or coordinators may obtain or administer any medical assistance or treatment the player/Travellers may reasonably require, including contacting their doctor.

I accept liability for all reasonable costs incurred by the department in obtaining such medical assistance or treatment (including any transportation costs) and undertake to reimburse the department the full amount of those costs.

I have provided Runcorn Rockets Basketball Club Inc in this registration with all relevant details of the player/Travellers medical or physical needs on registration/enrolment and where relevant have updated this information.

I confirm that I will advise a Runcorn Rockets Basketball Club Inc committee members or coordinator before leaving any venue/hotel etc where not directed to do so by a Runcorn Rockets Basketball Club Inc committee members or coordinator.

All players phones are required to be given to a travelling adult by 9pm each night and will be available at breakfast.

I will abide by all instructions and directions provided by the Travel Guide and Runcorn Rockets Basketball Club Inc committee members or coordinators.

I will conduct myself and endeavour to ensure others in my company conduct themselves in a proper and reasonable manner and in accordance with Basketball’s Codes of Conduct, a copy of which is available from Basketball Australia, Basketball Queensland, and South Western Metro Basketball Association, Runcorn Rockets or from their internet sites.

I agree to be bound by the Runcorn Rockets, South Western Metro Basketball Association ’s, Basketball Australia’s and Basketball Queensland’s constitution, rules and by-laws and the conditions of entry into the basketball facility and to submit myself to the jurisdiction of their Tribunal, Member Protection Tribunal and any other disciplinary forum connected with basketball.

I agree to comply with any reasonable direction of any official connected with basketball.

I acknowledge that I am aware that there will only be limited times when a person qualified in first aid is present.

I authorise the club, association, league, Basketball Australia or Basketball Queensland to obtain medical treatment for me or my child should there be an emergency and it is not possible or reasonably practical for me to do so and acknowledge that the cost of any ambulance or medical treatment will be my sole responsibility.

I advise I have or my child has the following medical conditions including allergies and warrant that I am or my child is fit to play basketball and will notify the association should any new medical information become available:


Unless I delete any item I consent to the following:

a) I or my child’s name (but not address) may be mentioned in any newsletter (whether printed or electronic) in reports about games and achievements

b) I or my child may be photographed and any photograph used in any newsletter (whether printed or electronic) or for promotion of basketball

c) Videos may be taken of me or my child playing or training to be used for family keepsakes by family members of other players, or by or for coaching staff to be used for coaching or scouting purposes

d) Information about basketball will be sent to me from time to time by mail or email.

I will not photograph or video any activity in which I or my child is involved unless I make known to the coach or team manager who I am and that I propose to take photographs or video a game.

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

I will offer my services to assist the association in any way that I can in the conduct of competitions or otherwise and advise that I have the following particular qualifications or abilities which I am prepared to make available to the association from time to time:


Parent's Consent (for players under 18)

I/We being the mother/father/guardian of the above player who is under the age of eighteen guarantee due performance by the player of all terms and conditions of this agreement and to the extent that they also apply to me, agree to be bound by those same terms and conditions.



Note to Administrator

(for U18 list any medication required to be taken and or any medical condition we should be aware of)

Security Number : .
Please enter this number.