Registration

Participant Name*
First Last
Age*
Gender*
Participant country of birth*
Country
Language Spoken at Home*
Email*
Phone*
Address*
City Post Code
Emergency contact*
First Last phone
Emergency contact relationship to child
Does the participant suffer from any medical conditions or have any health conditions the coach should be aware of? If so, please specify:*
Program location*
- Port Melbourne
- Maidstone
- Cranbourne
Consent*
I Consent to the Terms and Conditions of Registration.