Loddon Hoopstars

Player's name *

First Name

Last Name

Player's birthdate *

MM

DD

YYYY

Photograph consent *

Yes, the player can have photographs taken

No, the player is not able to have photographs taken

First Aid consent *

Yes, the player can have first aid treatment given by a qualified first aider at a Hoopstars session

No, the player isn't allowed to have first aid treatment at a Hoopstars session

We have been awarded funding to support asylum seekers and refugees to participate in basketball. If you would like to receive financial support in the form of a free space for you or your child, please confirm your immigration status below: *

Asylum Seeker

Refugee

No Applicable