Term 2 2023 - Come n' Try Registration Form

Registration Form - Term 2 Come n' Try Program

Fill out the form carefully for registration
Participant Name

First NameMiddle NameLast Name
Birth Date

MonthDayYear
Gender identity of the participant
Suberb/ post code of residence (we ask this to assess where future programs may more accessible)
Guardian/ emergancy contact detail
Name

First NameLast Name
Phone Number
Please enter a valid phone number.
Email
example@example.com
What does the participant need to feel supported in this program? (we ask this so we can do what we can to make their expereince as accessible as possible)
Please list any medical conditions the participant has that the facilitators of the program should be aware of (i.e. asthma, epilepsy etc.)
As a person/ guardian with lived expereince, we would love to hear any suggestions or insights around how we can best deliver this program as a whole. Please type suggestions below:
Would you be avaliable to provide some support in the delivery of the program (this may look like throwing balls in during a drill if we are short a coach)?

YesNo
Additional Comments
Thank you for completing this form. Chloe (facilitator) will be in touch to discuss participant needs and program details shortly.
Should be Empty:

Registration Form - Term 2 Come n' Try Program