Senior Player Registration Form

Please fill out the form below OR download the a copy below and return the completed document either by fax, post or email.

Fax: (08) 8125 5766

Post: PO Box 72 Marden 5070

Email: [email protected]

Download Senior Player Registration Form

Senior Player Registration Form

The information below will be used for administration and communication by Norwood and Basketball SA. If any of the above information changes, please notify the Norwood Office.

Player's Name*
First Last
Address*
Street Address City State / Province / Region ZIP / Postal Code
Player's Mobile Phone*
Player's Home Phone
Player's Work Phone
Email (used for invoices)*
Date of Birth*
Current Team
Men's / Women's
- Men's
- Women's
Division
Playing Number
The Privacy Act requires that any person whose details appear on this form must sign the form.
Player's Signature*
- By checking this box I confirm that all of the above information is complete and correct and that it also acts as my electronic signature.

Senior Player Registration Form

Senior Player Registration Form

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