Expression of Interest to participate in VR program

Central Highlands Rural Health (CHRH) is running a three week Virtual Reality (VR) program for young people who live in the Clunes area and are aged 12 to 14 years!

The program aims to enhance physical activity using games that require movement. VR technology requires participants to put a ski-like mask over their eyes to view and enter a virtual world in which they can take part in a range of fun and interactive video games and/or activities.

The program will run over on a Monday afternoon and will be coordinated by a CHRH Health Promotion Officer and Social Worker. All employees hold a current Working with Children’s Check.

Please see program details below:

Program Dates: May 31st, June 7th and June 21st. 
Time: 4:30 - 5.30pm. Snack provided 
Location: Clunes (specific location TBC)
Cost: Free of charge 
*Parental permission is required

Spaces are strictly limited so if your child would like to express their interest in participating in this three week program, please  complete the following questions:

*The following information provided is collected in line with  CHRH Privacy Policy.

Note: If you have any questions please do not hesitate to contact Belinda Buck, Manager Population Health belinda.buck@chrh.org.au
This Expression of Interest should only take approximately 3 minutes to complete and must be completed to consider your application to participate in the VR program.

Question Title

* 1. Participants full name

Question Title

* 2. Participants date of birth

Question Title

* 3. Participants gender

Question Title

* 4. Is the participant of Aboriginal or Torres Strait Islander (TSI) origin?

Question Title

* 5. Country of birth

Question Title

* 6. Language spoken at home

Question Title

* 7. Participant email address (if applicable)

Question Title

* 8. What School does the participant attend (if applicable)

Question Title

* 9. Primary parent/carer contact details

Question Title

* 10. If the participant was successfully chosen to be on the program would they be able to attend all three sessions?

Thank you for completing this Expression of Interest.  A staff member at CHRH will be in contact with you shortly to advise if you were successful in your application to participate in the program.
0 of 10 answered
 

T