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FORM - I WANT TO PLAY GOALBALL
Date TBA
Test venue
Are you attending this event?
Yes
No
Maybe
Basic details
First name*
Last name*
Phone number*
Email address*
Address*
Additional information
Date of birth*
Confirm email address*
Have you played Goalball before*
Please select...
Yes
No
Where would you like to start playing Goalball*
Please select...
ACT
NSW
NT
QLD
SA
TAS
VIC
WA
Are you vision impaired/blind? If so, please provide further details on sight*
Max. 255 characters
Do you currently attend school, TAFE or University*
Please select...
Yes
No
If yes for above question, are you interested in having a demonstration in-school/TAFE/University
Please select...
Yes
No
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.*
Submit