Details

FORM - I WANT TO PLAY GOALBALL

Date TBA

Test venue

Are you attending this event?

Yes No Maybe

First name*

Last name*

Phone number*

Email address*

Address*

Date of birth*

Confirm email address*

Have you played Goalball before*

Where would you like to start playing Goalball*

Are you vision impaired/blind? If so, please provide further details on sight* Max. 255 characters

Do you currently attend school, TAFE or University*

If yes for above question, are you interested in having a demonstration in-school/TAFE/University

Emergency contact person (if under 18)

Emergency contact phone number (if under 18)

Additional information or questions Max. 255 characters

I am over 18, or, if I am under 18, this registration has been filled out by and endorsed by my parent or guardian.*