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Get Active Together Expression of Interest Form

Get Active Together Club Promotion Days and Pop Ups

Please submit this form 30 days prior to your Club Promotion Day or 15 working days ahead of booking your pop-up. City of Rockingham support cannot be guaranteed if this timeline is not met.
Collection Notice

The City of Rockingham is collecting the personal information provided on this form to process registrations for the Get Active Together registration process. It may also be used for secondary purposes which would be reasonably expected.

We may share this information with suppliers in order to complete your registration request.

If you choose not to provide the personal information, we may not be able to process the registration.

To access, correct or learn more about how we handle personal information please contact privacy@rockingham.wa.gov.au or visit rockingham.wa.gov.au/privacy.
1.Club name(Required.)
2.Contact name for main event organiser (for public display)(Required.)
3.Contact mobile number for event (for public display)(Required.)
4.Contact email address for event (for public display)(Required.)
5.What is the key target audience for your event?(Required.)
6.What is the confirmed date/s of your club promotion day/event?(Required.)
7.What Saturday/s do you want to book Churchill Park pop up space? Available on Saturdays only between 7am-10am, beginning Saturday 6 September 2025 and ending Saturday 30 May 2026. The City retains the right to refuse bookings.(Required.)
8.Title of your event and activities or attractions planned for the day(Required.)
9.What is the venue location and street address where the event will be held?(Required.)
10.Key message/s for the event(Required.)
11.Upload flyer and/or logo or other promotional materials
No file chosen
12.Select support you require assistance with(Required.)
13.Any other comments?