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?

Wednesday 18th December

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