CBL Player Nomination - Geelong Supercats

Name*

First Last

Date of Birth*

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Email*

Mobile*

What is the primary team you are nominating for?*

Are you currently playing Representative Basketball for Geelong or another Association?*

If applicable, which other Association are you currently playing for?

All Representative Players are expected to play domestic GBL competition. Please select the option that is most appropriate for you.*

I understand I need to play GBL and am already a registered and active member.
I understand I need to play GBL however require a club to play for.
I understand I need to play GBL however will be requesting an exemption if selected.

I understand there will be a $200 fee to participate in the 2018/19 CBL season*