Enrolment 2024

Participant Full Name *

First

Last

Preferred Name

Pronouns

She/Her

He/Him

They/Them

Date of Birth*

day

/

month

/

year

Address

Street Address City State / Province / Region Postal / Zip Code

Contact name (Parent, if under 18)

First

Last

Email *

Mobile Phone*

Home Phone*

1/4

First

Last

Parent 1 Address (if different to participant)

Street Address Street Address Line 2 City State / Province / Region Postal / Zip Code

Parent 1 Phone

Parent 1 Email

Parent 2 Name

First

Last

Parent 2 Address (if different to above)

Street Address Street Address Line 2 City State / Province / Region Postal / Zip Code

Parent 2 Phone

Parent 2 Email

Are there any parental orders in place?*

Yes

No

If yes, please provide details we should be aware of:

Private Health (if any)

Where appropriate, does the participant have any medical conditions/allergies/other.*

Yes

No

If yes, please provide details.

Is the participant currently taking prescription medication?*

Yes

No

Please note

Is the participant able to self administer medication?*

Yes

No

Do you give permission for the participant to be given Paracetamol if required?*

Yes

No

Are there any other details you would like to add to help coach the participant:

I agree to pay the required term fees by the third week of each term. If I/we can't financially afford the payments, I will contact the treasurer to make other payment arrangements. Failure to do this will result in cost recovery actions being taken from BCC by a debt collector.*

I agree

Hire Equipment - I agree to pay a replacement fee for loss or breakage of Hire clubs and rods. Rod - $15 - Clubs $50. *

I agree

Selected payment option*

I understand that a $50 family volunteer levy is charged to families in the first invoice of the year and will be refunded to those who have donated a minimum of three hours of volunteer time across the year. This fee is charged once per family, not per participant.*

I understand

I give permission for photos/videos of the participant to be used on the BCC Website or Social Media pages*

Yes

No

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Fee Schedule 2024

Enrolment Form