VIRTUAL CHALLENGE - REGISTRATION FORM

Welcome to the Get Active Central Highlands - Virtual Challenge!

Question Title

* 1. Name:

First name

Surname

Question Title

* 2. Email address:

Question Title

* 3. Phone number:

Question Title

* 4. Gender:

Female

Male

Non-binary

Prefer not to say

Prefer to self-describe

Question Title

* 5. Year of birth:

	Year
Year	Year Year menu

Question Title

* 6. Persons under 18 years of age must seek parental / guardian consent to enter into the Virtual Challenge. Confirm this consent has been provided:

Yes, consent provided.

Question Title

* 7. Country of birth:

Australia

Overseas

Question Title

* 8. Residential postcode (please enter your four digit postcode only):

Question Title

* 9. Are you of Aboriginal or Torres Strait Islander origin?

Yes

Don’t know /prefer not to say

Question Title

* 10. Do you identify as a person with disability?

Yes

Prefer not to say

Question Title

* 11. How you discovered the Virtual Challenge:

Facebook

Instragram

Website

Print media e.g. newspaper

Work place

Sporting club

School / University

Local council

Word of mouth / friends or family

Other (please specify)

Question Title

* 12. The sporting club, organisation or workplace you are representing (please write none if not applicable):

Question Title

* 13. Select the below option to opt out of receiving Sports Central's future email communications.

I do not want to receive future email communications

Question Title

* 14. Sports Central will be evaluating these activities. To help Sports Central gain an understanding of your current exercise habits there are a series of additional questions.

Do you wish to complete the questions, that should only take 1-2 minutes?

Yes

By registering for the Virtual Challenge, participants provide Sports Central permission to use their photo and video entries for marketing and promotional purposes.

All registered participants agree to abide by the competition's Terms and Conditions as outlined on the Sports Central website: https://sportscentral.org.au/get-active-central-highlands-virtual-challenge/

Question Title

* 1. Name:

Question Title

* 2. Email address:

Question Title

* 3. Phone number:

Question Title

* 4. Gender:

Question Title

* 5. Year of birth:

Question Title

* 6. Persons under 18 years of age must seek parental / guardian consent to enter into the Virtual Challenge. Confirm this consent has been provided:

Question Title

* 7. Country of birth:

Question Title

* 8. Residential postcode (please enter your four digit postcode only):

Question Title

* 9. Are you of Aboriginal or Torres Strait Islander origin?

Question Title

* 10. Do you identify as a person with disability?

Question Title

* 11. How you discovered the Virtual Challenge:

Question Title

* 12. The sporting club, organisation or workplace you are representing (please write none if not applicable):

Question Title

* 13. Select the below option to opt out of receiving Sports Central's future email communications.

Question Title

* 14. Sports Central will be evaluating these activities. To help Sports Central gain an understanding of your current exercise habits there are a series of additional questions. Do you wish to complete the questions, that should only take 1-2 minutes?

* 14. Sports Central will be evaluating these activities. To help Sports Central gain an understanding of your current exercise habits there are a series of additional questions.

Do you wish to complete the questions, that should only take 1-2 minutes?