AquaZone All-Abilities Gym Program

Thank you for your interest in the AquaZone All-Abilities Gym Program.

Please complete the survey below to confirm your eligibility for this program. We will contact you regarding the outcome and to confirm further details of the program.

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* 1. Name

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* 2. Please enter your age group

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* 3. Gender

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* 5. Phone

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* 6. Residential address

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* 7. University Name

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* 8. Program of Study

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* 9. Do you hold a Working with Children Check (WWCC)?

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* 10. Do you have a current AquaZone Gym Membership

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* 11. How would you prefer to receive communications regarding this program?

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* 12. Do you have any questions regarding participation in the program?

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* 13. How did you hear about the program?

Thank you for registering your interest. We will contact you via your preferred communication method to confirm your eligibility for this program and discuss further details of the program.
Privacy Notice- The personal information requested is being collected by Warrnambool City Council for the purpose of administering the AquaZone All-Abilities Gym Program. The personal information will not be disclosed to any other external party unless permitted under the Information Privacy Principles. If you wish to alter any of the personal information you have supplied to Warrnambool City Council, please contact Council via telephone 5559 4800 or email contact@warrnambool.vic.gov.au

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