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Recreational camps and day activities – expression of interest
Your contact details
*
1.
Your name (the person going on camp)
(Required.)
*
2.
Where you live
(Required.)
Address
*
Address 2
City/Town
*
State/Province
ZIP/Postal Code
*
3.
Your phone number
(Required.)
4.
Your gender
Male
Female
Transgender
Prefer not to say
Other
*
5.
How old are you?
(Required.)
*
6.
What is your disability?
(Required.)
*
7.
Who should we contact about this expression of interest?
(Required.)
Name
*
Address
*
Address 2
City/Town
*
State/Province
*
ZIP/Postal Code
*
Email Address
*
Phone Number
*
*
8.
What is the contact person's relationship to the person going on camp? For example, parent, guardian, carer, friend
(Required.)
