GippSport Street Games - Bass Coast Registration Form

Please be assured your answers will remain confidential.

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* 1. Parent or Guardian's Name?

First name

Surname

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* 2. What is your email address?

Please be assured your email address is only used for activity related information.

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* 3. Contact Number

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* 4. What postcode do you live in? (Please enter your four digit postcode only)

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* 5. Child's Name

First name

Surname

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* 6. Gender

Woman/Girl

Man/Boy

Non-binary

Prefer not to say

Prefer to self-describe

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* 7. Year of birth?

	Year
Year	Year Year menu

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* 8. Please select which dates you wish to attend

Friday March 5 (inverloch)

Friday March 12 (Corinella)

Friday March 19 (Grantville)

Friday March 26 (Corinella

Friday April 9 (Grantville)

Question Title

* 1. Parent or Guardian's Name?

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* 2. What is your email address?Please be assured your email address is only used for activity related information.

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* 3. Contact Number

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* 4. What postcode do you live in? (Please enter your four digit postcode only)

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* 5. Child's Name

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* 6. Gender

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* 7. Year of birth?

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* 8. Please select which dates you wish to attend

* 2. What is your email address?

Please be assured your email address is only used for activity related information.