Registration Form - All Abilities Hockey Program Survey

Wodonga Hockey Club and Sport North East

Join us for a friendly and social program where you'll be able to learn the basics of Hockey and connect with a club centered around family values, fun, and fairness.

This program is open to all ages and abilities. No experience is necessary!

Dates: Thursdays - 14th, 21st, 28th May and 4th June
Timing – 5:30pm to 6:30pm
Location: Wodonga Hockey Centre, Silva Dr, West Wodonga

For any queries or additional information, please contact Team Leader Sport North East - Dhanur Sharma at dhanur.sharma@thecentre.vic.edu.au or 0428 064 055

1.Participant's Full Name(Required.)

3.What is the participant's gender?(Required.)

Male

Female

Other

Prefer not to say

4.Parent/Guardian's Name
(if the participant is a minor)

5.Phone Number(Required.)

6.Email(Required.)

7.Does the participant have a disability?(Required.)

Yes

If you answered Yes (please provide details of the nature of disability - physical, intellectual, sensory, other)

8.Does the participant have any accessibility/modification requirements that will enable them to participate to their full potential?

9.Has the participant played Hockey before?(Required.)

Yes

12.Photos and videos of the program participants will be taken to share with our stakeholders and community for promotional use. This content may be used on the club, Sport North East and Wodonga Council's website, social media pages and newsletters. Do you grant us permission for the above?(Required.)

Yes

13.Do you have any other queries or any information that you would like to provide to us?