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SWMP 2019-2020 Rep Registration
Trial fee $30 - payable at sign in of first trial (cash or eftpos preferred payments)
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Email
*
Your email
Surname
*
Your answer
Given Names
*
Your answer
Gender
*
Male
Female
Year of Birth
*
Choose
2000
2001
2002
2003
2004
2005
2006
Email
*
Your answer
Confirm Email
*
Your answer
Emergency Contact Number
*
Mobile only
Your answer
Emergency Contact Name
*
Your answer
SWM Rego
*
Is player registered with South West Metro Basketball Association?
Yes
No
If Registered with SWM - Current Club
Choose
River City Hornets
Algester Hawks
Sunnybank Hills Hurricanes
Runcorn Rockets
Rochedale Wildcats
Cannons Southside
Other
Have you played Rep previously, if Yes please advise last Association you played for
*
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New to Rep
SWM
BBI
Ipswich
Northside
Seahawks GC
Gold Coast
Redlands
Logan
Southern Districts
Other
Additional Information
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