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Thanks for your interest in the 2019 season of the Robert Rose Foundation Victorian Wheelchair Football League. 

Please complete the form below with your details.

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* 1. Name:

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* 2. Gender:

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* 3. Mobile:

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* 4. Email:

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* 5. DOB:

Date of Birth

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* 6. Where do you live?

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* 8. I am interested in becoming:

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* 9. Do you identify as having a Physical Disability and/or Impairment?

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* 10. Did you participate in the inaugural season of the Victorian Wheelchair Football League?

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* 11. Have you previously played other wheelchair sports?

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* 12. Do you own a Sports Wheelchair?

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* 13. How did you find out about the Victorian Wheelchair Football League?

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* 14. Will you attend the Open Skills Session on Sunday 24 February 2019, 10am to 3pm at Darebin Community Sports Stadium?

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* 15. Will you attend the Draft Combine on Sunday 3 March 2019, 10am to 3pm at Boroondara Sports Complex?

Thanks for submitting your Expression of Interest we will be in contact soon with more information about the 2019 Robert Rose Foundation Victorian Wheelchair Football League season, and all of our upcoming events!

For more information please contact Scott Nicholas, AFL Victoria Disability Programs Manager on 0436 434 556 or scott.nicholas@afl.com.au.

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