Government Sports Voucher Online Claim Form

Eastern Mavericks District Basketball Club

Government Sports Voucher Online Claim Form:

🚨👉 Claims submitted with invalid information will not be accepted by the Office for Recreation, Sport and Racing (ORSR). Please read and respond to each question carefully.

This online form is for parents, guardians, or caregivers to claim a government-issued sports voucher that helps cover the cost of participating in basketball programs offered by the Eastern Mavericks District Basketball Club.
The voucher can be used to reduce fees associated with registration or membership for eligible children and young people.

Please ensure you have all the required information ready before starting your claim, including proof of eligibility, child’s details, and provider information. Claims must be submitted within the specified program dates.

I can confirm I have not made a claim for the Sports Voucher this calendar year.*

Bank Account Information for Refund:

Account Holder Full Name*

(Full name as registered with the bank)

Name of Bank*

(e.g., National Bank of Australia, ANZ Bank, etc.)

BSB Number (6 digits)*

(Enter “0” if not applicable)

Account Number (up to 9 digits)*

(Enter “0” if not applicable)

What voucher amount would you like to apply for?*

Child first name*

Child surname*

Child gender*

Child date of birth*

Street Address*

Suburb*

Postcode*

Australian Visa Number*

(N/A if not applicable)

Medicare number*

(10 digits) — Enter zero (0) if not applicable

Enter child's Medicare reference number*

(Single digit) — Enter zero (0) if not applicable

Parent/Guardian First Name*

Parent/Guardian Last Name*

Parent/Guardian Contact Number*

Enter mobile number without space, e.g. (+61401234567)

Parent/Guardian Email*

Is this the first time your child has joined this activity provider?*

Has your child been identified as living with a disability?*

Is your child from an Aboriginal or Torres Strait Islander background?*

Is English the main language spoken at home?*

What is the cost to participate in this activity?*

Use numbers only (no letters or special characters)

Voucher is being claimed for, select from the following*

By submitting this voucher, I authorise Eastern Mavericks Basketball Club to share my child's information with the Office for Recreation, Sport and Racing.*

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Government Sports Voucher Online Claim Form

Bank Account Information for Refund:

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