BASKETBALL BALLARAT
2017 CHAMPIONSHIP SEASON
CLEARANCE FORM
Clearances close 5pm, 27/03/2017
Name:………………………………………………………………………………………
Date of Birth: ………………………… Age Group…………………………
Mobil................................................ Home Phone.....................................................Email………………………………………………….
Did you play a game during the 2016/17 Summer season in any team?
YES
NO
Have you notified the club you are clearing from of your intention?
YES
NO
Have you contacted your new club and been advised of a position there?
YES
NO
Have you played representative basketball for Ballarat in the last 12 months (27/3/16 to now)?
YES
NO
Request to have my registration transferred from ………………………...(Current Club) to …………………………….(New Club)
Signed: ………………………………………
Signature of player
Date:
Signed: ……………………………………… (Parent or Guardian)
If player is under18, a parent or guardian must counter sign this form.
CLUB CLEARANCE APPROVAL
Must be actioned within 7 days of receipt. Failure to return this form within the 7 days from date forwarded to Club, will results in an
automatic clearance being granted.
I, ………………………………………………….(Secretary) of …………………………………………Basketball Club
Certify that the clearance of the above applicant has been
If declined – Reason
1.Unpaid fees
APPROVED / DECLINED
2. Uniform not returned
Signed: ………………………………………………..
3. Signed intention to play form
Date: ………………………………………………….
Position held with Club: …………………………………………(Form must be signed by Secretary/President of Club)
*Please read carefully through back of this page
Basketball Office Use Only
Date received from Player ………………….
Position available at new club
Advised by:
Yes / No
Date forwarded to Club ……………………
Due to be returned
………………………..
Date Returned by Club …………………….
APPROVED/DECLINED
Basketball Manager – Matt Newton
Signature ……………… ………. Date……………………
Cash/Eftpos/Cheque
$26 TRANSFER FEE MUST ACCOMPANY THIS CLEARANCE FORM
BASKETBALL BALLARAT DOMESTIC CLEARANCE DETAILS
PLAYER CLEARANCE FORM
1. Player seeking clearance must register form and pay $26 transfer fee with Basketball Manager. This can be
completed by paying at the Basketball Office between 9am and 5pm Monday to Friday, or placing the clearance
form directly into the “DOMESTIC CLEARANCE FORM ONLY” box in the hallway of the MARS MINERDOME. This
box will be checked daily.
2. Request will be registered with Basketball Manager and forwarded to Club. PLEASE NOTE CLEARANCE
FORMS WILL NOT BE SENT TO CLUBS UNTIL THE CLEARANCES HAVE CLOSED. CLUBS WILL
HAVE UNTIL 5pm Monday April 3 to respond.
3. Club has 7 days to return and respond to application.
FAILURE TO RETURN BY DUE DATE WILL SEE AN AUTOMATIC CLEARANCE ISSUED.
4. Basketball Manager will notify player of outcome of application.
5. For full clearance By-Law details please go to http://ballaratbasketball.com/basketball-association/policiesdocuments/
6. Players are not allowed to play for their new club until notified; failure to adhere to this will result in
immediate loss of match points for the new team.
7. No clearance will be approved if the wrong clearance form is used. Only 2017 Championship Season
clearance forms are approved.
$26 TRANSFER FEE MUST ACCOMPANY THIS CLEARANCE FORM