Membership

Kilrush Basketball Club
Registration Form

* Please note that due to shortages of coaching staff preferences will be given to returning players and we may need to REDUCE team numbers - notice will be given post registration - KBC Committee

* Indicates required field

Player One Name *

First

Last

Player BI Number: *

Player One Date of Birth *

Select One: *

Player Two *

First

Last

Player BI Number: *

Player Two Date of Birth *

Select One: *

Player Three *

First

Last

Player BI Number: *

Player Three Date of Birth *

Select One: *

Name of Parent / Guardian *

Contact Phone Number of Parent / Guardian *

Email Address *

Home Address *

Any Medical Conditions / Allergies *

I/We understand that there are potential risks in playing basketball.
I/We have received copies of the parents and players Code of Conduct and we are committed to complying with these.
I/We give permission to photographs/video to be taken of our child, occasionally these images may appear in the media/social media.
I/We confirm that our child does not have a medical condition that would make playing the sport of Basketball a health risk for him/her or others.
I/We understand that the club will require €2.00 to be paid to the coach at the beginning of each training session & another fee (approx. €3) prior to each competitive match to pay referees.
I/We understand that the Club accept no responsibility for loss, damage or injury caused by or during attendance on any of the clubs organised activities, except where such loss, damage or injury can be shown to result directly from the negligence of the Club or the Organisers.
I, confirm that my child is below the age of 16 years old and I am hereby consenting on his/her behalf that Kilrush Basketball Club can process his/her personal data for the purpose of registration with Basketball Ireland and KBC, Training Information and Blitz planning.
I am aware that I may withdraw his/her consent at any time by using the “PARENTAL CONSENT WITHDRAWAL FORM available from any member of the club.
Due to Covid 19, there may be Covid Control Measures at Training and Matches.
I/We understand Training and Match venues may alter to indoor and outdoor due to restrictions. This will be weather dependent and cancellations may occur during the season. All parents will be given as much notice as possible of any cancellation or change of venue.
I/We confirm that any Player or non–playing staff with a temperature or any symptoms should not attend training or any facility or event. They should contact their doctor or primary care doctor to establish the best course of action.

Kilrush Basketball Club is compliant with the requirements of GDPR and our Privacy Policy Statement is available from our Club Secretary.

Please also note:
We will be travelling to blitz’s/event over the season. It will be parents/guardians responsibility to drive or arrange a lift with another parent/guardian to a blitz/event. We would welcome any assistance with transport and support for the teams from parents. There may be additional costs associated with a blitz to cover costs of referees. Details will be given to you prior to the date.

I have read and understand the above terms and conditions and fully agree *

Yes, I agree & understand No, I don't agree or understand

Submit

Membership

Kilrush Basketball Club​Registration Form

Kilrush Basketball Club
Registration Form