March 2026 Geelong All Abilities - Registration
If you would like to participate in a FREE All Abilities program for players with a disability, please fill in this form to register. We will reach out to you with more information.
Program Selection
Which Program would you like to register for?
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North Geelong Warriors FC (Lara) Thursdays 5.45pm-6.45pm ALL AGES
FC Leopold (Leopold) Saturdays 10.00am-11.00am AGES 6-18
Please note, that these programs are run in collaboration between Football Victoria and clubs. This means that your registration information will be shared between your club of participation and Football Victoria (Governing body).
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Yes, I understand.
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Participant Registration Details
Participant name
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First Name
Last Name
Date of birth
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Month
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Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Gender
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Suburb of residence
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Participant's Disability (Optional) Please note that this program is for participants with a disability
Are there any medical conditions we should be aware of (e.g. asthma, seizures, allergies)?
Behviour Support Plan
Does the participant have a Behaviour Support Plan or other support strategies that would help our coaches understand how to best support them during sessions?
Yes
No
Behviour Support Plan Upload. (Optional) If shared, these will be kept highly confidential between Football Victoria, the club and coaches.
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Photo Permission
Do you give permission for photos or videos of the participant to be taken and used for program promotion (e.g., on social media, website, or reports) by your club, Football Victoria and partners?
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Yes
No
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Parent/guardian/carer details
Please provide the following contact details.
Name
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First Name
Last Name
Email
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example@example.com
Phone Number
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Please enter a valid phone number.
Format: (000) 000-0000.
Relationship to participant
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Other Information (Optional)
Is there anything we can do during the session to ensure the participant feels most supported?
Is there anything else we may need to know?
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