Participant Information

Participant First Name

Participant Last Name

Date of Birth

Mobile

Suburb

How many programs would you like to attend?

Select the number of days you wish to attend below.

Which program/s are you registering for?

Monday 13th January

Tuesday 14th January

Thursday 23rd January

2 Days

All 3 Days

Please ensure the number of programs chosen is in line with your above selection

Payment

Please make sure you have selected the correct number of days you wish to attend.

Credit Card Number

Expiry Date

CVC/CVV

I acknowledge that Brisbane Basketball will not process refunds for participants that withdraw within 48-hours of their select programs