Team Registration - Bellarine Peninsula Basketball Association

Team Details

Club (if applicable)

Team name*

Did this team previously play in a BPBA competition under another name*

Yes
No

If so, what was the team name

Venue Preference (applicable for Mon & Wed juniors only)

Drysdale
Ocean Grove

Coach/Team Manager (must be 18 years or older)

Name*

First Last

Date of birth*

Email*

Phone*

Address*

Street Address Address Line 2 City Postcode

State*

Do you have a Working With Children Check*

WWCC is COMPULSORY for all Team Mangers and Coaches

WWCC Number*

Working With Children Check

Drop files here or

Additional Contact

Name*

First Last

Email*

Phone*

Competition

Monday

Social Women | From 9:30am | Ocean Grove | 2005 or older
Under 10 Girls | From 4:00pm | Drys/O-Grove | 2011 to 2014
Under 12 Girls | From 4:00pm | Drys/O-Grove | 2009 to 2010
Under 14 Girls | From 4:00pm | Drys/O-Grove | 2007 to 2008
Under 16 Girls | From 5:00pm | Drys/O-Grove | 2005 to 2006
Under 18 Girls | From 5:00pm | Drys/O-Grove | 2003 to 2004
Women (Div 1-3) | From 6:00pm | Drysdale | 2005 or older

Tuesday

Under 18 Boys | From 5:00pm | Drysdale | 2003 to 2004
Under 21 Boys | From 5:00pm | Drysdale | 2000 to 2002
Masters Men | From 6:30pm | Drysdale | 1989 or older
Social Mixed | From 6:30pm | Drysdale | 2005 or older

Wednesday

Under 10 Boys | From 4:00pm | Drys/O-Grove | 2011 to 2014
Under 12 Boys | From 4:00pm | Drys/OG/STIG/CC | 2009 to 2010
Men (Div1-5) | From 6:30pm | Drys/STIG/OG | 2005 of older

Thursday

Under 14 Boys | From 4:00pm | Drys/STIG/CC | 2007 to 2008
Under 16 Boys | From 6:00pm | Drys/STIG/CC | 2005 to 2006
Men (Div 6) | From 7:30pm | Drys/STIG/CC 2005 or older

Preferred Division*

Player List

Name

First Last

Number

Date Of Birth

School (Juniors Only)

More Information

Did player play in Winter 19 for this team
Has this player played representative for ANY association in 2018 or 2019

Name

First Last

Playing Number

Date Of Birth

School (Juniors Only)

More Information

Did player play in Winter 19 for this team
Has this player played representative for ANY association in 2018 or 2019

Name

First Last

Playing Number

Date Of Birth

School (Juniors Only)

More Information

Did player play in Winter 19 for this team
Has this player played representative for ANY association in 2018 or 2019

Name

First Last

Playing Number

Date Of Birth

School (Juniors Only)

More Information

Did player play in Winter 19 for this team
Has this player played representative for ANY association in 2018 or 2019

Name

First Last

Playing Number

Date Of Birth

School (Juniors Only)

More Information

Did player play in Winter 19 for this team
Has this player played representative for ANY association in 2018 or 2019

Name

First Last

Playing Number

Date Of Birth

School (Juniors Only)

More Information

Did player play in Winter 19 for this team
Has this player played representative for ANY association in 2018 or 2019

Name

First Last

Playing Number

Date Of Birth

School (Juniors Only)

More Information

Did player play in Winter 19 for this team
Has this player played representative for ANY association in 2018 or 2019

Name

First Last

Playing Number

Date Of Birth

School (Juniors Only)

More Information

Did player play in Winter 19 for this team
Has this player played representative for ANY association in 2018 or 2019

Name

First Last

Playing Number

Date Of Birth

School (Juniors Only)

More Information

Did player play in Winter 19 for this team
Has this player played representative for ANY association in 2018 or 2019

Name

First Last

Playing Number

Date Of Birth

School (Juniors Only)

More Information

Did player play in Winter 19 for this team
Has this player played representative for ANY association in 2018 or 2019

Does your team require additional players?*

If so, how many?

Team Registration*

Price: $ 70.00

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