Registration & Payment

Runcorn Rockets Basketball - Season 1, 2024

Registration Form only for Volunteers and Train only (Age 12+)

* Required

Season *

Basic Info - Volunteers & Train Only(Age 12+)

Type of Registration *

Please tick all the boxes that apply to you.

Is this your first time registering with Rockets?

Given Name *
Surname *
Date of Birth (e.g. 15/07/2015)
Gender *

Preferred Email Address *

Email address to receive invoices/receipts, notifications, etc.

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

Mobile Phone, Home Phone, Work Phone, etc.

Address *
Suburb *
Post Code *
Current School (if applicable)

Required only for 'Player' or 'Training only (No game)'

Blue Card No. (if applicable)

Required only for 'Coach' or 'Other volunteer'

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

Given Name
Email Address (Cc)
Preferred Contact Number

Mobile Phone, Home Phone, Work Phone, etc.


Parent/Guardian Details - Secondary Contact

Given Name
Email Address
Preferred Contact Number

Mobile Phone, Home Phone, Work Phone, etc.


Fee Payment
(* Required only for "Training Only")

Age Group & Seasonal Membership Fee
Payment Method

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.


Player Declaration / Parent Consent *

Player's Declaration

I, Hereby agree as follows:

  • 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. I will endeavour to be present or ensure a responsible adult is present at all games, training sessions and other basketball activities in which my child is involved.

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

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