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Walking Football Participant EOI
This form is to submit your interest in playing Walking Football in Victoria
6
Questions
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1
Name
*
This field is required.
First Name
Last Name
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2
Mobile Number
*
This field is required.
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3
Email
*
This field is required.
example@example.com
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4
What suburb do you live in?
*
This field is required.
This will help us find your closest program
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5
Gender
*
This field is required.
Male
Female
N/A
Male
Female
N/A
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6
Age Group
*
This field is required.
Under 50s
50 - 60
60 - 70
70+
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Should be Empty:
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