Junior Representative Commitment 2021

The contact and medical information collected in this form will be collated and distributed to your child's team Coach and Manager for their reference while your child is in their care.

Players Name

First Last

Players Date of Birth

Player type

Team Selected in

Please select the team your child has been placed in

Parent/ Guardian Name

Parent/ Guardian Phone

Parent/ Guardian Email

Alternate or Emergency Contact Name

Do you wish to provide an alternate or emergency contact ?

Alternate or Emergency Contact Relationship to Child

Alternate or Emergency Contact Email

Alternate or Emergency Contact Phone

General Information

Please provide any information regarding home life that the Coach or Manager should be aware of.

Medical conditions

Does your child suffer from any medical condition that the Coach or Manager should be aware of? If Yes, please provide details

Allergies

Does your child suffer from any allergies that the Coach or Manager should be aware of? If Yes, please provide details.

The following information will only be used in an emergency situation if the parent or emergency contact is not available.

Medicare Number

Position on Medicare Card

Private Health Fund Name

Private Health Fund Number

Are you covered for ambulance services

Yes
No

Consent

In the event of any accident or illness incurred during a SDBA sanctioned game or training session, I authorise the obtaining on my behalf of such medical assistance by licensed medical personnel, as my child may require. I accept full responsibility for all expenses incurred. I release and agree to hold SDBA harmless from any claims due to illness suffered by my child in the course of receiving such medical treatment and consequences that may arise as the result of this treatment.

I agree to medical assistance being sought in my absence

Acceptance

REPRESENTATIVE PLAYER & PARENT AGREEMENT:

To represent Sutherland Basketball Association is a privilege not to be taken lightly. Involvement in our Representative Program not only reflects outstanding individual skills but also implies a sound understanding of the positive philosophies of development, teamwork and sportsmanship.
Please read the The Sutherland Sharks Representative Information for the 2022 Season on the SDBA Website.
This document outlines the minimum standard of performance and behaviour expected of all players & parents involved with the Sutherland Basketball Association Representative Program in accepting a position within a SDBA Representative team:

We have read and accept the Player/Family agreement

Acceptance

We have read ,understand and will abide by the BNSW Codes of Conduct for Players and Spectators and the BNSW Zero Tolerance Policy

Fees

I understand that there are fees associated with playing representative basketball for Sutherland Basketball Association.

I agree to pay all fees outlined by the due date..

Local Competition Commitment

All junior representative players are required to play in the Sutherland Basketball Association 2021/22 Local Competition. Players will be deemed to have taken part in Local Competition by qualifying for finals. If there is a legitimate reason a player cannot fulfill this commitment they will need to apply in writing to the Representative Manager for an exemption.

I understand thaI understand that my child is required to play local competition for Sutherland Basketball.

Use of Photographs

I understand that SDBA and BNSW will use photographs and some personal information on the SDBA & BNSW website and in various literature, newsletters and related publications and agree to the reasonable use of such photographs and information.

I agree to the use of Photos

Junior Representative Player Information and Agreement

Resources

Links

Junior Representative Commitment 2021

Junior Representative Player Information and Agreement

Resources

Links

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