(* denotes field is mandatory)
Date of Birth*: (in some browsers, reqd format is yyyy-mm-dd)
Ethnicity: Mixed – White and Black BritishMixed – White and Black AfricanMixed – White and AsianMixed – OtherAsian or Asian British – IndianAsian or Asian British – PakistanAsian or Asian British – BangladeshiAsian or Asian British – OtherBlack or Black British – CaribbeanBlack or Black British – AfricanBlack or Black British – OtherWhite – BritishWhite – IrishWhite – OtherChineseOther Ethnic Group
Parent Contact Details
(Medical conditions, dietary requirements, allergies etc, if none add N/A)
Please advise in the text area below on your child's dates of attendance.
How did you hear about us?*: A family member already attendsFrom a friendFrom a friend / parent of my childOnline searchNews itemFrom a School teacherFrom Basketball EnglandOther
Please advise if you have any objections to the player being included in promotional photography or videos relating to the camp or the club. Answer*: NoYes
I would like to receive updates about upcoming news and events and club information from City of Birmingham Rockets Basketball Club via,
SMSEmailTelephonePostI would not like to be contacted
TO CONFIRM ATTENDANCE, PLEASE PRESS 'SEND'.
After pressing "SEND" proceed to make the payment using the details below: Amounts are £6 per day for Club Members or £12 per day for Non-club Members.
Pay by Bank Transfer
Account Name: City of Birmingham Basketball
Account Number: 21487450
Sort Code: 40-32-03