Play Our Way registration form

First Name

Last Name

Phone number *

Email Address

Postal address (if email not supplied)

Street address

City

State

Postcode

Guardian name *

Guardian phone number (if different from above)

Guardian email (if different from above)

Yes, my child/ward may participate in the Play Our Way program

The participants may be occasionally photographed/filmed during the Play Our Way program, and these images and videos may be used to promote future activities

Yes, this is fineNo, I do not wish for me (or my child/ward) to be filmed or photographed

Other activity of interest

In what way are you interested in developing your skills? *

Have you played sport or been involved in any physical activity in the last year?

YesNo

If other, what was your barrier?